V-Y quadricepsplasty in total knee arthroplasty

The results in 14 consecutive patients (16 knees) who have had total knee arthroplasty (TKA) with a V-Y quadricepsplasty were reviewed. There were eight men and six women with an average age of 66.2 years. Nine patients (ten knees) had revision arthroplasty and five patients (six knees) had primary arthroplasty. Nine of the 14 patients were examined and evaluated in the biomechanics laboratory using the modified Cybex-II system at a mean of three years from surgery. Using the knee rating score of the Hospital for Special Surgery, there were two excellent, ten good, two fair, and two poor results. The average active range of motion was 4° to 85°. Biomechanical testing revealed statistically significant weakness in extension compared with the contralateral side only at test speeds of 120, 180, and 240° per second in those patients who had contralateral normal knees. The affected side at other test speeds were weaker but did not reach statistically significant weakness when compared with the contralateral knee. Comparing V-Y quadricepsplasty to normal medial parapatellar TKA patients, the extensor mechanism was weaker in the V-Y group but not to a significant degree. If one requires a V-Y quadricepsplasty during TKA, one can expect near normal active extension and moderate weakness in extension. Knee scores reflect the difficult reconstructive challenges that are inherent in patients who require a V-Y quadricepsplasty.