Allograft Transplantation in Cases of Insufficiency of Knee Extensor Mechanism Following Total Knee Arthroplasty
Hackl, Wolfgang |
Recenzentas / Reviewer | |
Komisijos pirmininkas / Committee Chairman | |
Komisijos narys / Committee Member | |
Komisijos narys / Committee Member | |
Komisijos narys / Committee Member | |
Komisijos narys / Committee Member |
Background: Rupture of the knee extensor mechanism following total knee arthroplasty (TKA) is rare, but serious and devastating complication. Classification includes three types of rupture: suprapatellar (quadriceps tendon rupture), transpatellar (patellar fracture) and infrapatellar (patellar ligament rupture). Management of the knee extensor mechanism insufficiency ranges from conservative treatment to various reconstruction techniques. In this article we will try to describe our experience with the allograft transplantation and evaluate this technique as a method to reconstruct insufficient extensor mechanism following TKA. Methods: A retrospective analysis of three patients with the insufficient knee extensor mechanism after TKA, who underwent reconstruction surgery with the knee extensor mechanism allograft at the Department of Orthopedics, the University Hospital of Innsbruck, Austria. Results: Our cases showed ambigous results with the first patient achieving great success and satisfying functional results, the second one, who did not manage to reach the great functional lever, highly possible due to previous medical conditions and old age, and lastly the third patient, who did not avoid several postoperative complications. Conclusions: Just like most of the studies in the litarature, we are also not able to draw definitive conclusions, nevertheless, with the adequate patient choice, a great success may be reached. We would recommend allograft transplantation technique as a useful alternative to treat insufficient knee extensor mechanism, however, more bigger case series or systematic reviews have to be done, in order to evaluate, which of the many techniques promise the best outcome.
Background: Rupture of the knee extensor mechanism following total knee arthroplasty (TKA) is rare, but serious and devastating complication. Classification includes three types of rupture: suprapatellar (quadriceps tendon rupture), transpatellar (patellar fracture) and infrapatellar (patellar ligament rupture). Management of the knee extensor mechanism insufficiency ranges from conservative treatment to various reconstruction techniques. In this article we will try to describe our experience with the allograft transplantation and evaluate this technique as a method to reconstruct insufficient extensor mechanism following TKA. Methods: A retrospective analysis of three patients with the insufficient knee extensor mechanism after TKA, who underwent reconstruction surgery with the knee extensor mechanism allograft at the Department of Orthopedics, the University Hospital of Innsbruck, Austria. Results: Our cases showed ambigous results with the first patient achieving great success and satisfying functional results, the second one, who did not manage to reach the great functional lever, highly possible due to previous medical conditions and old age, and lastly the third patient, who did not avoid several postoperative complications. Conclusions: Just like most of the studies in the litarature, we are also not able to draw definitive conclusions, nevertheless, with the adequate patient choice, a great success may be reached. We would recommend allograft transplantation technique as a useful alternative to treat insufficient knee extensor mechanism, however, more bigger case series or systematic reviews have to be done, in order to evaluate, which of the many techniques promise the best outcome.