title: Treating extensor mechanism disruption after total knee arthroplasty.
abstract: A consecutive series of 14 patients with chronic extensor mechanism disruption after total knee arthroplasty (TKA) were treated with allograft reconstruction. Preoperatively all patients had full passive extension but a complete extensor lag. The average time from extensor mechanism disruption to surgery was 7 months (range, 3-24 months). Two methods of reconstruction were used depending on specific indications: an Achilles tendon with calcaneal bone block (eight patients) or a quadriceps tendon-patella-patellar tendon-tibial tubercle composite graft (six patients). At followup averaging 42 months (range, 24-60 months) all patients were community ambulators, five patients used a cane, two patients used a walker, and seven patients used no assistive devices. One patient had a partial rerupture and a 45 degrees extensor lag, one patient had a 30 degrees extensor lag, two patients had a 15 degrees extensor lag, and 10 patients had a lag of less than 10 degrees. All patients thought that their functional status had been improved and were satisfied with the results of the allograft reconstruction.
authors.affiliation: Department of Orthopaedic Surgery, Tulane University Health Sciences Center, New Orleans, LA 70012, USA. rbarrack@tulane..edu
authors.forename: Robert L
authors.initials: RL
authors.lastname: Barrack
authors.forename: Tom
authors.initials: T
authors.lastname: Stanley
authors.forename: R
authors.initials: R
authors.lastname: Allen Butler
mesh_terms: D000125:Achilles Tendon / Q000637:transplantation; D019645:Arthroplasty, Replacement, Knee; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D018482:Muscle, Skeletal / Q000637:transplantation; D019637:Orthopedic Procedures / Q000379:methods*; D010147:Pain Measurement; D011183:Postoperative Complications / Q000601:surgery*; D016059:Range of Motion, Articular; D012421:Rupture; D013708:Tendon Injuries / Q000209:etiology / Q000601:surgery*; D013710:Tendons / Q000637:transplantation; D014184:Transplantation, Homologous; D016896:Treatment Outcome