Outcomes After Knee Joint Extensor Mechanism Disruptions

Tejwani, Nirmal C.; Lekic, Nikola; Bechtel, Christopher; Montero, Nicole; Egol, Kenneth A

doi:10.1097/bot.0b013e31824a3bb5

Cited by 25 publications

(25 citation statements)

References 12 publications

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“…This is in agreement with the fact that almost all tendon ruptures of the knee extensor apparatus occur after a degenerative and inflammatory process, which is more pronounced in the tendinous midsection and in osteotendinous junction in which the tendon resistance is significantly reduced and the risk of rupture, increased 7, 8, 9. The older age range observed in patients with rupture of the quadriceps tendon is consistent with the literature 3 . A longer waiting time until surgery presented significantly lower Kujala scores, which is consistent with results obtained by other authors 2, 14, 15, 16.…”

Section: Discussionsupporting

confidence: 91%

“…Patellar fractures are more frequent than tendinous ruptures, in ratios ranging from 17:1 to 43:1; ruptures of the quadriceps tendon are more frequent than those of the patellar tendon 1, 2. These injuries require surgical reconstruction of the extensor apparatus in order to recover the extension function 3 . To date, only one study has directly compared clinical and functional results of patellar fractures and tendinous rupture of the extensor apparatus of the knee 3 …”

Section: Introductionmentioning

confidence: 99%

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Total ruptures of the extensor apparatus of the knee

Moura

Fonseca

2016

Revista Brasileira de Ortopedia (English Edition)

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ObjectiveThis was a retrospective case-control study on total ruptures of the extensor apparatus of the knee, aimed to compare patella fractures with tendinous ruptures.MethodsThe sample included 190 patients and 198 total ruptures of the knee extensor apparatus. All patients were evaluated by the same examiner after a minimum one-year follow-up.ResultsTendinous ruptures occurred most frequently in men, in younger patients, and had better clinical and functional outcomes when compared with patella fractures; however, the former presented higher levels of thigh atrophy. Patella fractures occurred most frequently in women and in older patients and caused most frequently caused residual pain, muscle weakness, and limitations in daily activities. Comminuted fractures were related to high-energy trauma, lower clinical and functional outcomes, and higher levels of residual pain and osteosynthesis failure. Early removal of osteosynthesis material was related to better outcomes. Regarding the tendinous ruptures, over half of the patients presented risk conditions for tendinous degeneration; a longer delay until surgery was related to lower Kujala scores.ConclusionThe surgical repair of bilateral ruptures of the knee extensor apparatus resulted in satisfactory clinical and functional outcomes, which were better for tendinous ruptures when compared with patella fractures. However, these lesions are associated with non-negligible levels of residual pain, muscle weakness, atrophy, and other complications.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Total ruptures of the extensor apparatus of the knee

Moura

Fonseca

2016

Revista Brasileira de Ortopedia (English Edition)

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“…However, patients with PFs had lower thigh circumferences during the fi rst year. 8 Contrary to our assumption, it appears that whatever the injury, the outcomes are similar and that we can expect our patients to do well whatever the nature of their injuries.…”

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confidence: 45%

Trauma

2013

Bone & Joint 360

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“…Along with other soft-tissue injuries that affect elderly patients, such as Achilles tendon rupture (ATR), patellar tendon rupture (PTR), rotator cuff (RC) lesions, and biceps tendon rupture (BTR), quadriceps tendon rupture (QTR) can also be seen as an end stage of chronic tendon degeneration and overuse [15, 24]. Moreover, knee extensor mechanism injuries may also result from quadriceps or patellar tendon rupture or patellar fractures (PF) [9, 12, 23]. More than half of such injuries are PFs, and they usually occur in older female patients [9, 23].…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, knee extensor mechanism injuries may also result from quadriceps or patellar tendon rupture or patellar fractures (PF) [9, 12, 23]. More than half of such injuries are PFs, and they usually occur in older female patients [9, 23]. Traditionally, QTR has been regarded as a relatively rare soft-tissue injury that affects elderly patients [6].…”

Section: Introductionmentioning

confidence: 99%

The increasing incidence of surgically treated quadriceps tendon ruptures

Reito

Paloneva

Mattila

et al. 2019

Knee Surg Sports Traumatol Arthrosc

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PurposeDue to increased life expectancy and a more active life style of the older people, we hypothesised that the incidence of quadriceps tendon rupture (QTR) is higher than previously reported. The objective of this nationwide population-based study was to investigate the annual incidence of QTR in patients who underwent operative treatment in Finland between 1997 and 2014.MethodsThe Finnish National Hospital Discharge Register was searched for all adult patients who had undergone surgical treatment for QTR during the study period. Population-based annual incidence and incidence trends for surgically treated QTR were calculated.ResultsDuring the study period, 1343 QTR surgeries were performed. Of these, 90% were performed on male patients. The incidence of QTR increased by 411% from 0.55 to 2.82 per 100,000 person-years from 1997 to 2014. The average yearly increase in the number of surgeries was 9.0%. In male patients, the incidence of QTR increased by 490% and in female patients by 121%. The mean age of the male patients increased during the study period from 50 to 59 years.ConclusionsBased on the data from the Finnish National Hospital Discharge Register, the annual incidence of QTR increased by over 400% during the 18-year study period. The average age of the patients also increased. Because QTR is only very rarely treated without surgery, the results of our study can be considered to be a reliable estimate of the increase in the incidence of this condition. There is an urgent need to establish the risk factors associated with QTR and to also establish the optimal surgical technique.Level of evidenceIV.Electronic supplementary materialThe online version of this article (10.1007/s00167-019-05453-y) contains supplementary material, which is available to authorized users.

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Outcomes After Knee Joint Extensor Mechanism Disruptions

Abstract: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Cited by 25 publications

References 12 publications

Total ruptures of the extensor apparatus of the knee

Total ruptures of the extensor apparatus of the knee

Trauma

The increasing incidence of surgically treated quadriceps tendon ruptures

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