Survivorship of Extensor Mechanism Allograft Reconstruction After Total Knee Arthroplasty

Ricciardi, Benjamin F.; Oi, Kathryn K.; Trivellas, Andromahi; Lee, Yuo-yu; Valle, A. González-Della; Westrich, Geoffrey H.

doi:10.1016/j.arth.2016.06.031

Cited by 46 publications

(26 citation statements)

References 18 publications

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“…Given their lower prevalence than more distal extensor mechanism ruptures, the epidemiology, management, and outcomes of quadriceps tendon tears after TKA are less often reported in the literature [3] . Strategies for quadriceps tendon repair after TKA include primary repair with suture anchors or transosseous tunnels (usually for acute tears in the immediate postoperative period); augmentation of the repair with hamstring autograft, allograft, or synthetic mesh; and allograft reconstruction of the entire extensor mechanism, which may be performed with or without revision of TKA components [3] , [6] , [7] , [8] , [9] .…”

Section: Introductionmentioning

confidence: 99%

Retrieval analysis of a failed synthetic mesh extensor mechanism reconstruction after total knee arthroplasty

2018

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Extensor mechanism disruption after total knee arthroplasty is a relatively rare but potentially devastating complication. One technique to address this problem involves reconstruction with synthetic mesh. Although there are reports of successful clinical outcomes using this technique, we are not aware of any histological analyses of removed mesh grafts. This case report of a failed mesh reconstruction includes a retrieval analysis demonstrating robust host soft-tissue incorporation into the mesh graft and supports the rationale for continued use of this off-label technique. This case report also highlights the need for careful operative technique when performing these procedures to increase the chance of a successful outcome.

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Section: Introductionmentioning

confidence: 99%

Retrieval analysis of a failed synthetic mesh extensor mechanism reconstruction after total knee arthroplasty

2018

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“… 8 , 9 A systematic review by Shau et al found a failure rate of approximately 25% in both methods. 10 Survival rates were also similar for the two techniques in a meta-analysis performed by Deren et al 8 However, most of the studies included in these reviews had a follow-up of fewer than 5 years (only Ricciardi et al 11 reported a follow-up of more than 5 years for the allograft technique) and a reduced number of studied knees (only Ricciardi et al, Brown et al and Diaz-Ledezma et al, who used an Achilles tendon, presented series with more than 20 knees using allografts). 11 – 13 …”

Section: Introductionmentioning

confidence: 87%

Extensor Mechanism Transplantation After Knee Prosthesis: 70-Month Follow-Up

et al. 2022

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Objective: This article reports the range of motion, failure rate, and complications of patients with extensor mechanism injury after total knee arthroplasty (TKA) treated with extensor mechanism allograft with mid-term follow-up. Methods: Patients undergoing post-ATJ extensor mechanism transplantation from 2009 to 2018 were retrospectively evaluated. Demographics, the reason for transplantation, elapsed time from arthroplasty to transplantation, related surgical factors, immobilization time, range of motion, transplant failure, and complications were collected. The minimum follow-up was 24 months. Results: Twenty patients were evaluated. The mean follow-up was 70.8 +/- 33.6 months. The most common cause of extensor mechanism rupture was traumatic in 10 (50%) cases. Six patients underwent associated surgeries, one case of medial ligament complex reconstruction, and 5 cases of TKA revision. Eleven patients (55%) had transplant-related complications. The most common complication was an infection. Five cases presented transplant failure. Conclusion: Patients who underwent extensor mechanism allograft transplantation after total knee arthroplasty had a 25% failure rate with a mean follow-up of 6 years. Although there was no loss of flexion with the procedure and prolonged immobilization, the complication rate was not low. Level of evidence IV; case series .

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“… 1 Quadriceps tendon (QT) rupture is relatively uncommon (1.3%–4%). 2 , 3 Sometimes diagnosis may require radiological evaluation. 4 Reconstruction of chronic quadriceps tendon injuries (CQTI) is challenging and has poor outcomes.…”

Section: Introductionmentioning

confidence: 99%

Chronic Quadriceps Tendon Rupture Reconstruction with Sartorius Muscle Transfer: A Report of Five Cases

Elhessy

Alrabai

Eltayeby

et al. 2021

Plastic and Reconstructive Surgery - Global Open

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Summary: Disruption of the knee extensor mechanism is an unfavorable situation because efficient mobilization requires a functioning knee extensor apparatus. The purpose of this retrospective study was to report our technique of sartorius muscle transfer for restoration of extension mechanism function and the outcomes of five patients. Patients with ruptured knee extensor mechanism secondary to trauma or knee arthroplasty-related issues were studied retrospectively. In all patients, sartorius muscle was transferred to restore the quadriceps tension deficit. Increase in the knee active range of motion, increase in the extensor mechanism power by one grade on Medical Research Council scale, and improvement in the extension lag were observed in all patients. The sartorius muscle transfer can be a reliable option to restore the knee extensor mechanism in chronic quadriceps tendon injuries. Our initial results are promising and showed improvement of the extensor mechanism muscle power, increased knee active range of motion, and decreased knee extension lag. The complications we observed did not impair the successful outcome of the sartorius transfer and were anticipated given the complexity of the studied cases. We encourage additional studies of sartorius muscle transfer to treat chronic quadriceps tendon injuries.

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Survivorship of Extensor Mechanism Allograft Reconstruction After Total Knee Arthroplasty

Cited by 46 publications

References 18 publications

Retrieval analysis of a failed synthetic mesh extensor mechanism reconstruction after total knee arthroplasty

Retrieval analysis of a failed synthetic mesh extensor mechanism reconstruction after total knee arthroplasty

Extensor Mechanism Transplantation After Knee Prosthesis: 70-Month Follow-Up

Chronic Quadriceps Tendon Rupture Reconstruction with Sartorius Muscle Transfer: A Report of Five Cases

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