[Patellar tendon injuries after total knee arthroplasty : Classification and management]

Area of Science:

• Orthopedic Surgery
• Biomaterials Science
• Reconstructive Surgery

Background:

• Patellar tendon ruptures are rare but severe complications following total knee arthroplasty (TKA).
• These ruptures typically necessitate surgical intervention for effective management.

Purpose of the Study:

• To develop a comprehensive classification system for patellar tendon ruptures occurring after TKA.
• To establish a corresponding therapeutic algorithm based on current literature and clinical experience.

Main Methods:

• A thorough review of existing medical literature was conducted.
• The authors' clinical experience was integrated with the literature review.
• A classification system and treatment algorithm were formulated based on the synthesized information.

Main Results:

• Patellar tendon ruptures are categorized into avulsions (Type I), acute (Type II), and chronic (Type III).
• Treatment strategies vary based on rupture type, tendon quality, bone stock, and patient comorbidities, involving techniques like refixation, primary suture with cerclage, tendon augmentation, flaps, and in severe cases, patellectomy or arthrodesis.

Conclusions:

• The proposed classification and algorithm provide a structured approach to managing patellar tendon ruptures after TKA.
• Tailored surgical strategies, considering specific rupture characteristics and patient factors, are crucial for optimizing treatment outcomes.