Open Debridement and Proximal Z-Plasty For Arthrofibrosis
The open debridement began with a 6 inch incision thru my previous incision. This incision has been opened up 8 times. Scar tissue was removed anteriorly, infrapatellar, medially. After this debridement, the doctor went on to perform a proximal z-plasty.
A Z-plasty is a surgical technique where the surgical cut is made in a Z fashion. This is used anywhere there is tight tissue. It provides a controlled and gradual release of tight tissues. It's use is not confined to Orthopaedics. Other surgeons such as Plastic surgeons, use it for scar revisions.
My proximal z-plasty was done to tight/contracted medial and lateral tissue of the patella, which also included scar tissue.( I also learned not all scar tissue can be removed because of it's location) This was NOT done to the retinacular tissue.(I previously had a z plasty to the lateral retinaculum, for patella decompression and a z-plasty to a tight IT band) These tight lateral and medial tissues were cut in a Z fashion, they were pulled apart and placed in a single layer, then stiched down, to prevent herniating ( according to my PT ) This is not a common procedure, as the medical staff was learning about this procedure, as the doctor explained it to me, complete with pictures.
If I understood this explanation correctly, this is how a proximal z-plasty of the knee, is done.