Evolution of the quadriceps snip.

Between May 1990 and December 1992, the quadriceps snip was used to assist in the surgical exposure of the knee in 16 patients (4 women and 12 men) who underwent knee surgery at the average age of 65 years (range, 50-73 years). The original diagnoses included osteoarthritis (12 patients), traumatic arthritis (2 patients), rheumatoid arthritis (1 patient), and psoriatic arthritis (1 patient). The surgical exposure was done in the treatment of aseptic loosening of a total knee prosthesis in 8 patients, septic loosening in 2 patients, and primary knee arthroplasty in 6 patients with fibrous ankylosis. Using the Hospital for Special Surgery Scoring System, the authors rated the knees of 10 patients as excellent and those of 6 patients as good at postoperative evaluation. The range of motion was improved in all knees by an average of 30 degrees. Cybex testing revealed significant weakness of the knee in extension when compared with the contralateral normal side at test speeds of 60 degrees and 180 degrees per second but no difference compared with the opposite knee that had been replaced. In the authors' experience, the surgical technique of a quadriceps snip has been safe and simple, has not required special equipment, and postoperatively the patient's physical therapy has not had to be altered. Clinically, the quadriceps strength was very good, although weaker than that of a contralateral normal leg when measured by Cybex testing.