Management of extensor mechanism deficit as a consequence of patellar tendon loss in total knee arthroplasty: a new surgical technique.
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.
Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India.
Rajesh
R
Malhotra
Bhavuk
B
Garg
Vivek
V
Logani
Surya
S
Bhan
D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000502:physiology; D008297:Male; D010329:Patella / Q000601:surgery*; D017847:Patellar Ligament / Q000502:physiology / Q000601:surgery* / Q000637:transplantation*; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D012086:Reoperation / Q000379:methods*; D013977:Tibia / Q000601:surgery*; D014184:Transplantation, Homologous; D016896:Treatment Outcome