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Clinical and Biomechanical Outcomes following Knee Extensor Mechanism Reconstruction.

Berkcan Akpinar1, Samuel Baron1, Michael J Alaia1

  • 1Department of Orthopedic Surgery, New York University Langone Medical Center, New York, New York, U.S.A.

Arthroscopy, Sports Medicine, and Rehabilitation
|November 2, 2020
PubMed
Summary

Knee extensor mechanism reconstruction (KEMR) significantly improves patient-reported outcomes and reduces extension lag. However, persistent strength deficits were observed postoperatively in patients undergoing KEMR.

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Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Rehabilitation Medicine

Background:

  • Knee extensor mechanism injuries can lead to significant functional deficits.
  • Restoring the extensor mechanism is crucial for knee function and patient mobility.
  • Previous studies have shown varied outcomes following surgical reconstruction.

Purpose of the Study:

  • To evaluate the clinical and biomechanical results of knee extensor mechanism reconstruction (KEMR).
  • To assess patient-reported outcomes and isokinetic strength after KEMR.

Main Methods:

  • A case series of 12 patients undergoing KEMR between 2011 and 2018 was retrospectively reviewed.
  • Clinical outcomes were assessed using Kujala, Lysholm, and Tegner Activity Scale scores.
  • Isokinetic testing (Biodex) was performed on a subset of 9 patients to evaluate knee extensor strength.

Main Results:

  • Significant improvements were noted in Tegner, Kujala scores, and reduction in extension lag post-KEMR.
  • No significant difference in passive range of motion was found between operative and contralateral knees.
  • Operative knees demonstrated decreased maximum work generated and range of motion at all tested speeds compared to the contralateral knee.

Conclusions:

  • Knee extensor mechanism reconstruction leads to significant improvements in clinical outcomes and patient-reported function.
  • Despite clinical gains, persistent strength deficits in knee extensor power remain postoperatively.