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Research Article: A modified quadriceps snip technique in primary total knee arthroplasty for hemophilic stiff knees: a retrospective case series

Date Published: 2026-05-21

Abstract:
This retrospective case series was conducted to evaluate the effects of the modified quadriceps snip technique applied during primary total knee arthroplasty (TKA) in patients with end-stage hemophilic arthritis. A total of 9 patients (10 knees) with hemophilic stiff knees who underwent primary TKA using the modified quadriceps snip technique between January 2022 and June 2023 were retrospectively reviewed. The primary outcome was defined as the improvement in knee range of motion (ROM) from baseline to the final follow-up. Secondary outcomes included the Knee Society Score (KSS) clinical and functional scores and Hemophilia Joint Health Score version 2.1 (HJHS 2.1). ROM improved significantly from 19.5 ± 11.17° preoperatively to 80 ± 11.54° postoperatively (60.50°, 95% CI: 48.29°–72.71°, p < 0.01). KSS clinical scores increased from 28.4 ± 20.46 to 70 ± 21.21 (41.60, 95% CI: 25.67–57.53, p < 0.01), and KSS functional scores improved from 42.25 ± 20.85 to 78 ± 25.85 (33.50, 95% CI: 18.60–48.40, p < 0.01). HJHS 2.1 scores decreased from 32 ± 8.65 to 18.1 ± 9.01 (13.90, 95% CI: -17.72 to -10.08, p < 0.01). No cases of infection, implant loosening, or revision surgery were recorded at the final follow-up, with a mean follow-up of 21 months (range: 16–34 months). In this case series, the modified quadriceps snip technique was associated with improvements in knee range of motion and clinical scores. These preliminary findings suggest that prospective controlled studies are still warranted to validate its clinical value.

Introduction:
This retrospective case series was conducted to evaluate the effects of the modified quadriceps snip technique applied during primary total knee arthroplasty (TKA) in patients with end-stage hemophilic arthritis.

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