Knee mobility in femoral lengthening using Ilizarov's method

Muscle contracture and joint stiffness are a major concern during limb lengthening using the Ilizarov method. The aim of this study was to detect factors that may influence the final loss of knee flexion. We retrospectively studied knee movement in 32 patients undergoing femoral lengthening using the Ilizarov method. The pattern of loss of knee movement showed a rapid fall in knee flexion during the latency period between operation and start of distraction, and the flexion loss continued during lengthening. There was a relationship between the worst knee range of motion achieved during lengthening and the final loss of knee flexion. Intensive physical therapy is necessary in the latency period, because there is a rapid decrease in knee flexion, as well as during the whole lengthening procedure, in which flexion loss continues. Despite the flexion loss, patients finally regain good knee function after removal of the external fixator.