Patellar tendon rupture after total knee arthroplasty.

Area of Science:

• Orthopedic Surgery
• Biomaterials Science
• Reconstructive Surgery

Background:

• Patellar tendon rupture is a known complication following total knee arthroplasty (TKA).
• This complication can significantly impair knee function and patient outcomes.
• Identifying risk factors and optimizing treatment strategies are crucial for managing these challenging cases.

Purpose of the Study:

• To evaluate the incidence and outcomes of patellar tendon ruptures after TKA.
• To assess the effectiveness of different surgical repair methods.
• To identify factors associated with complications and poor results.

Main Methods:

• Retrospective review of 18 patellar tendon ruptures in 17 patients treated between 1973 and 1985.
• Analysis of patient history, including prior procedures like distal patellar realignment and knee manipulation.
• Evaluation of surgical treatments including xenograft reconstruction and staple fixation.
• Assessment of follow-up outcomes, including functional recovery and complication rates, particularly deep infection.

Main Results:

• Patellar tendon ruptures occurred in 0.17% of TKAs during the study period.
• Four ruptures were associated with prior distal patellar realignment, and one with knee manipulation.
• Surgical repair outcomes were poor: only 2 xenograft reconstructions and 2 of 4 staple fixations were successful.
• Four knees developed deep infection after patellar tendon rupture repair.

Conclusions:

• Patellar tendon rupture after TKA is associated with discouraging treatment outcomes.
• Deep infection is a significant complication that must be avoided.
• Patients with limited preoperative motion and difficult surgical exposure during primary TKA may be at higher risk.