Extensor mechanism failure in total knee arthroplasty

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Reconstructive Surgery

Background:

• Extensor mechanism failure in total knee arthroplasty (TKA) encompasses quadriceps tendon rupture, patella fracture, and patella tendon rupture.
• Risk factors include component malrotation, elevated joint line, and prior lateral release.
• Conservative treatment is viable for partial ruptures or undisplaced fractures with preserved function.

Purpose of the Study:

• To review the management strategies for extensor mechanism failure following TKA.
• To delineate indications for conservative versus operative treatment.
• To discuss repair and reconstruction techniques for tendon ruptures.

Main Methods:

• Literature review of extensor mechanism failure in TKA.
• Analysis of risk factors and clinical presentations.
• Evaluation of treatment outcomes for conservative, operative repair, and reconstruction methods.

Main Results:

• Operative treatment is indicated for TKA extensor mechanism failure with functional disruption, to prevent poor outcomes and extensor lag.
• Acute patella or quadriceps tendon ruptures benefit from augmented repair due to high re-rupture risk.
• Chronic ruptures necessitate reconstruction using autograft, allograft, or synthetic materials due to high repair failure rates.

Conclusions:

• Timely diagnosis and appropriate management are crucial for successful outcomes in TKA extensor mechanism failure.
• Augmented repair for acute ruptures and reconstruction for chronic ruptures are essential to restore function.
• Understanding risk factors aids in preventing these debilitating complications.