Management of extensor mechanism deficit as a consequence of patellar tendon loss in total knee arthroplasty: a new surgical technique

J Arthroplasty. 2008 Dec;23(8):1146-51. doi: 10.1016/j.arth.2007.08.011. Epub 2008 Jan 24.

Abstract

Extensor mechanism disruption is an uncommon but devastating complication of total knee arthroplasty. A new technique of extensor mechanism reconstruction for patellar tendon loss, after total knee arthroplasty, with the help of extensor mechanism composite allograft is described. Four patients with chronic extensor mechanism-deficient total knee arthroplasty were undertaken for revision surgery along with reconstruction of extensor mechanism with an innovative technique using an extensor mechanism composite allograft consisting of a patella-patellar tendon-tibial tubercle. On final follow-up, none of the patients had extensor lag but for 10 degrees of extensor lag in 1 patient only. Providing an environment for bone-to-bone healing both proximally as well as distally and supervised postoperative rehabilitation led to encouraging results in the management of a failed extensor mechanism after total knee arthroplasty.

MeSH terms

  • Aged
  • Arthroplasty, Replacement, Knee / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Knee Joint / diagnostic imaging
  • Knee Joint / physiology
  • Male
  • Patella / surgery*
  • Patellar Ligament / physiology
  • Patellar Ligament / surgery*
  • Patellar Ligament / transplantation*
  • Radiography
  • Range of Motion, Articular / physiology
  • Reoperation / methods*
  • Tibia / surgery*
  • Transplantation, Homologous
  • Treatment Outcome