Status and treatment of knee extension device disruption after total knee arthroplasty_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LI Tiejian ^1,2 , DU Yinqiao ¹ , SUN Jingyang ¹ , SHEN Junmin ¹ , ZHANG Bohan ¹ ,  ZHOU Yonggang ¹

1. Medical School of Chinese PLA, Beijing, 100853, P.R.China;
2. Department of Orthopedics, the First Medical Centre, Chinese PLA General Hospital, Beijing, 100853, P.R.China;

Corresponding author：

ZHOU Yonggang, Email: zhouyg@263.net

Keywords：

Total knee arthroplasty; knee extension device; disruption; treatment method

DOI：

10.7507/1002-1892.202010015

Video：

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Objective To summarize the principle, classification, and treatment methods of knee extension device disruption after total knee arthroplasty (TKA).Methods By extensively consulted the relevant domestic and abroad literature, the principle, classification, and treatment methods of injury according to different parts of the knee extension device after TKA were summarized and analyzed.Results The knee extension device disruption after TKA mainly occurs in the quadriceps tendon, patella tendon, and patella. Once the knee extension device is injured, it will seriously affect the functional recovery of the patient after surgery, resulting in delayed knee extension, limited range of motion, difficulty walking, and joint pain, etc. The current treatment methods are diverse, including conservative treatment and surgical treatment. Surgical treatment includes direct suture repair (traditional perosseous fixation and suture anchoring techniques), reconstruction and reinforcement repair (reconstruction using synthetic patches, autografts, and allografts). For the treatment of different parts, it is necessary to comprehensively consider the patient’s knee joint tissue condition, the presence or absence of underlying diseases, and the presence or absence of donors.Conclusion There is no uniform conclusion on the treatment of knee extension device disruption after TKA. Different injury situations need to be considered comprehensively to choose the appropriate treatment method.

Citation： LI Tiejian, DU Yinqiao, SUN Jingyang, SHEN Junmin, ZHANG Bohan, ZHOU Yonggang. Status and treatment of knee extension device disruption after total knee arthroplasty. Chinese Journal of Reparative and Reconstructive Surgery, 2021, 35(4): 502-507. doi: 10.7507/1002-1892.202010015 Copy

1.	Vaishya R, Agarwal AK, Vijay V. Extensor mechanism disruption after total knee arthroplasty: A case series and review of literature. Cureus, 2016, 8(2): e479.
2.	Bates MD, Springer BD. Extensor mechanism disruption after total knee arthroplasty. J Am Acad Orthop Surg, 2015, 23(2): 95-106.
3.	Bonnin M, Lustig S, Huten D. Extensor tendon ruptures after total knee arthroplasty. Orthop Traumatol Surg Res, 2016, 102(1 Suppl): S21-31.
4.	Chalidis BE, Tsiridis E, Tragas AA, et al. Management of periprosthetic patellar fractures. A systematic review of literature. Injury, 2007, 38(6): 714-724.
5.	Vajapey SP, Blackwell RE, Maki AJ, et al. Treatment of extensor tendon disruption after total knee arthroplasty: A systematic review. J Arthroplasty, 2019, 34(6): 1279-1286.
6.	Papalia R, Vasta S, D’Adamio S, et al. Complications involving the extensor mechanism after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc, 2015, 23(12): 3501-3515.
7.	Fernandez-Baillo N, Garay EG, Ordoñez JM. Rupture of the quadriceps tendon after total knee arthroplasty. A case report. J Arthroplasty, 1993, 8(3): 331-333.
8.	Pagnano MW. Patellar tendon and quadriceps tendon tears after total knee arthroplasty. J Knee Surg, 2003, 16(4): 242-247.
9.	Leopold SS, Greidanus N, Paprosky WG, et al. High rate of failure of allograft reconstruction of the extensor mechanism after total knee arthroplasty. J Bone Joint Surg (Am), 1999, 81(11): 1574-1579.
10.	Nazarian DG, Booth RE. Extensor mechanism allografts in total knee arthroplasty. Clin Orthop Relat Res, 1999, (367): 123-129.
11.	Springer BD, Della Valle CJ. Extensor mechanism allograft reconstruction after total knee arthroplasty. J Arthroplasty, 2008, 23(7 Suppl): 35-38.
12.	Brown NM, Murray T, Sporer SM, et al. Extensor mechanism allograft reconstruction for extensor mechanism failure following total knee arthroplasty. J Bone Joint Surg (Am), 2015, 97(4): 279-283.
13.	Burnett RS, Butler RA, Barrack RL. Extensor mechanism allograft reconstruction in TKA at a mean of 56 months. Clin Orthop Relat Res, 2006, 452: 159-165.
14.	Dobbs RE, Hanssen AD, Lewallen DG, et al. Quadriceps tendon rupture after total knee arthroplasty. Prevalence, complications, and outcomes. J Bone Joint Surg (Am), 2005, 87(1): 37-45.
15.	Lynch AF, Rorabeck CH, Bourne RB. Extensor mechanism complications following total knee arthroplasty. J Arthroplasty, 1987, 2(2): 135-140.
16.	Yun AG, Rubash HE, Scott RD, et al. Quadriceps rupture associated with a proximal quadriceps release in total knee arthroplasty. A report of three cases. J Bone Joint Surg (Am), 2003, 85(9): 1809-1811.
17.	Bushnell BD, Byram IR, Weinhold PS, et al. The use of suture anchors in repair of the ruptured patellar tendon: a biomechanical study. Am J Sports Med, 2006, 34(9): 1492-1499.
18.	Maniscalco P, Bertone C, Rivera F, et al. A new method of repair for quadriceps tendon ruptures. A case report. Panminerva Med, 2000, 42(3): 223-225.
19.	Ilan DI, Tejwani N, Keschner M, et al. Quadriceps tendon rupture. J Am Acad Orthop Surg, 2003, 11(3): 192-200.
20.	Patt HH. Marlex mesh grafts in inguinal hernia repair. Arch Surg, 1967, 94(5): 734-736.
21.	Browne JA, Hanssen AD. Reconstruction of patellar tendon disruption after total knee arthroplasty: results of a new technique utilizing synthetic mesh. J Bone Joint Surg (Am), 2011, 93(12): 1137-1143.
22.	Nodzo SR, Rachala SR. Polypropylene mesh augmentation for complete quadriceps rupture after total knee arthroplasty. Knee, 2016, 23(1): 177-180.
23.	Morrey MC, Barlow JD, Abdel MP, et al. Synthetic mesh augmentation of acute and subacute quadriceps tendon repair. Orthopedics, 2016, 39(1): e9-13.
24.	Jaureguito JW, Dubois CM, Smith SR, et al. Medial gastrocnemius transposition flap for the treatment of disruption of the extensor mechanism after total knee arthroplasty. J Bone Joint Surg (Am), 1997, 79(6): 866-873.
25.	Busfield BT, Huffman GR, Nahai F, et al. Extended medial gastrocnemius rotational flap for treatment of chronic knee extensor mechanism deficiency in patients with and without total knee arthroplasty. Clin Orthop Relat Res, 2004, (428): 190-197.
26.	Whiteside LA. Surgical technique: vastus medialis and vastus lateralis as flflap transfer for knee extensor mechanism defificiency. Clin Orthop Relat Res, 2013, 471: 221-300.
27.	Emerson RH, Head WC, Malinin TI. Reconstruction of patellar tendon rupture after total knee arthroplasty with an extensor mechanism allograft. Clin Orthop Relat Res, 1990, (260): 154-161.
28.	Cadambi A, Engh GA. Use of a semitendinosus tendon autogenous graft for rupture of the patellar ligament after total knee arthroplasty. A report of seven cases. J Bone Joint Surg (Am), 1992, 74(7): 974-979.
29.	Frizziero A, Fini M, Salamanna F, et al. Effect of training and sudden detraining on the patellar tendon and its enthesis in rats. BMC Musculoskelet Disord, 2011, 19: 12.
30.	Abdel MP, Salib CG, Mara KC. Extensor mechanism reconstruction with use of marlex mesh: A series study of 77 total knee arthroplasties. J Bone Joint Surg (Am), 2018, 100(15): 1309-1318.
31.	马云青, 张蔷, 张洪. 聚丙烯网状补片加强缝合辅助修复人工全膝关节置换术髌腱断裂三例. 中国修复重建外科杂志, 2020, 34(90): 1002-1892.
32.	高东, 郑江, 张宪, 等. 锚钉修复联合半腱肌转移治疗陈旧性髌腱断裂. 中国矫形外科杂志, 2020, (28): 1005-8478.
33.	Pérez-García A, Esteban-Vico JR, García-Sánchez JM. Autologous patellar tendon reconstruction after total knee arthroplasty infection with skin loss: Anatomical study and case report. J Knee Surg, 2020, 332(2): 1538-8506.
34.	Crossett LS, Sinha RK, Sechriest VF, et al. Reconstruction of a ruptured patellar tendon with achilles tendon allograft following total knee arthroplasty. J Bone Joint Surg (Am), 2002, 84(8): 1354-1361.
35.	Lamberti A, Balato G, Summa PP, et al. Surgical options for chronic patellar tendon rupture in total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc, 2018, 26(5): 1429-1435.
36.	Ortiguera CJ, Berry DJ. Patellar fracture after total knee arthroplasty. J Bone Joint Surg (Am), 2002, 84(4): 532-540.
37.	Deren ME, Pannu TS, Villa JM, et al. Meta-analysis comparing allograft to synthetic reconstruction for extensor mechanism disruption after total knee arthroplasty. J Knee Surg, 2019. doi: 10.1055/s-0039-1696656.
38.	Shau D, Patton R, Patel S, et al. Synthetic mesh vs. allograft extensor mechanism reconstruction in total knee arthroplasty-A systematic review of the literature and meta-analysis. Knee, 2018, 25(1): 2-7.
39.	Parker DA, Dunbar MJ, Rorabeck CH. Extensor mechanism failure associated with total knee arthroplasty: prevention and management. J Am Acad Orthop Surg, 2003, 11(4): 238-247.
40.	Tria AJ, Harwood DA, Alicea JA, et al. Patellar fractures in posterior stabilized knee arthroplasties. Clin Orthop Relat Res, 1994, (299): 131-138.
41.	Scott RD, Turoff N, Ewald FC. Stress fracture of the patella following duopatellar total knee arthroplasty with patellar resurfacing. Clin Orthop Relat Res, 1982, (170): 147-151.
42.	Adigweme OO, Sassoon AA, Langford J, et al. Periprosthetic patellar fractures. J Knee Surg, 2013, 26(5): 313-317.
43.	Keating EM, Haas G, Meding JB. Patella fracture after post total knee replacements. Clin Orthop Relat Res, 2003, (416): 93-97.
44.	赵学寨, 孟彩云, 刘明辉, 等. 氨甲环酸不同用药方案对同期双侧全膝关节置换术围术期患者出血及术后并发症的影响. 中国药房, 2017, 28(18): 2486-2489.

1. Vaishya R, Agarwal AK, Vijay V. Extensor mechanism disruption after total knee arthroplasty: A case series and review of literature. Cureus, 2016, 8(2): e479.
2. Bates MD, Springer BD. Extensor mechanism disruption after total knee arthroplasty. J Am Acad Orthop Surg, 2015, 23(2): 95-106.
3. Bonnin M, Lustig S, Huten D. Extensor tendon ruptures after total knee arthroplasty. Orthop Traumatol Surg Res, 2016, 102(1 Suppl): S21-31.
4. Chalidis BE, Tsiridis E, Tragas AA, et al. Management of periprosthetic patellar fractures. A systematic review of literature. Injury, 2007, 38(6): 714-724.
5. Vajapey SP, Blackwell RE, Maki AJ, et al. Treatment of extensor tendon disruption after total knee arthroplasty: A systematic review. J Arthroplasty, 2019, 34(6): 1279-1286.
6. Papalia R, Vasta S, D’Adamio S, et al. Complications involving the extensor mechanism after total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc, 2015, 23(12): 3501-3515.
7. Fernandez-Baillo N, Garay EG, Ordoñez JM. Rupture of the quadriceps tendon after total knee arthroplasty. A case report. J Arthroplasty, 1993, 8(3): 331-333.
8. Pagnano MW. Patellar tendon and quadriceps tendon tears after total knee arthroplasty. J Knee Surg, 2003, 16(4): 242-247.
9. Leopold SS, Greidanus N, Paprosky WG, et al. High rate of failure of allograft reconstruction of the extensor mechanism after total knee arthroplasty. J Bone Joint Surg (Am), 1999, 81(11): 1574-1579.
10. Nazarian DG, Booth RE. Extensor mechanism allografts in total knee arthroplasty. Clin Orthop Relat Res, 1999, (367): 123-129.
11. Springer BD, Della Valle CJ. Extensor mechanism allograft reconstruction after total knee arthroplasty. J Arthroplasty, 2008, 23(7 Suppl): 35-38.
12. Brown NM, Murray T, Sporer SM, et al. Extensor mechanism allograft reconstruction for extensor mechanism failure following total knee arthroplasty. J Bone Joint Surg (Am), 2015, 97(4): 279-283.
13. Burnett RS, Butler RA, Barrack RL. Extensor mechanism allograft reconstruction in TKA at a mean of 56 months. Clin Orthop Relat Res, 2006, 452: 159-165.
14. Dobbs RE, Hanssen AD, Lewallen DG, et al. Quadriceps tendon rupture after total knee arthroplasty. Prevalence, complications, and outcomes. J Bone Joint Surg (Am), 2005, 87(1): 37-45.
15. Lynch AF, Rorabeck CH, Bourne RB. Extensor mechanism complications following total knee arthroplasty. J Arthroplasty, 1987, 2(2): 135-140.
16. Yun AG, Rubash HE, Scott RD, et al. Quadriceps rupture associated with a proximal quadriceps release in total knee arthroplasty. A report of three cases. J Bone Joint Surg (Am), 2003, 85(9): 1809-1811.
17. Bushnell BD, Byram IR, Weinhold PS, et al. The use of suture anchors in repair of the ruptured patellar tendon: a biomechanical study. Am J Sports Med, 2006, 34(9): 1492-1499.
18. Maniscalco P, Bertone C, Rivera F, et al. A new method of repair for quadriceps tendon ruptures. A case report. Panminerva Med, 2000, 42(3): 223-225.
19. Ilan DI, Tejwani N, Keschner M, et al. Quadriceps tendon rupture. J Am Acad Orthop Surg, 2003, 11(3): 192-200.
20. Patt HH. Marlex mesh grafts in inguinal hernia repair. Arch Surg, 1967, 94(5): 734-736.
21. Browne JA, Hanssen AD. Reconstruction of patellar tendon disruption after total knee arthroplasty: results of a new technique utilizing synthetic mesh. J Bone Joint Surg (Am), 2011, 93(12): 1137-1143.
22. Nodzo SR, Rachala SR. Polypropylene mesh augmentation for complete quadriceps rupture after total knee arthroplasty. Knee, 2016, 23(1): 177-180.
23. Morrey MC, Barlow JD, Abdel MP, et al. Synthetic mesh augmentation of acute and subacute quadriceps tendon repair. Orthopedics, 2016, 39(1): e9-13.
24. Jaureguito JW, Dubois CM, Smith SR, et al. Medial gastrocnemius transposition flap for the treatment of disruption of the extensor mechanism after total knee arthroplasty. J Bone Joint Surg (Am), 1997, 79(6): 866-873.
25. Busfield BT, Huffman GR, Nahai F, et al. Extended medial gastrocnemius rotational flap for treatment of chronic knee extensor mechanism deficiency in patients with and without total knee arthroplasty. Clin Orthop Relat Res, 2004, (428): 190-197.
26. Whiteside LA. Surgical technique: vastus medialis and vastus lateralis as flflap transfer for knee extensor mechanism defificiency. Clin Orthop Relat Res, 2013, 471: 221-300.
27. Emerson RH, Head WC, Malinin TI. Reconstruction of patellar tendon rupture after total knee arthroplasty with an extensor mechanism allograft. Clin Orthop Relat Res, 1990, (260): 154-161.
28. Cadambi A, Engh GA. Use of a semitendinosus tendon autogenous graft for rupture of the patellar ligament after total knee arthroplasty. A report of seven cases. J Bone Joint Surg (Am), 1992, 74(7): 974-979.
29. Frizziero A, Fini M, Salamanna F, et al. Effect of training and sudden detraining on the patellar tendon and its enthesis in rats. BMC Musculoskelet Disord, 2011, 19: 12.
30. Abdel MP, Salib CG, Mara KC. Extensor mechanism reconstruction with use of marlex mesh: A series study of 77 total knee arthroplasties. J Bone Joint Surg (Am), 2018, 100(15): 1309-1318.
31. 马云青, 张蔷, 张洪. 聚丙烯网状补片加强缝合辅助修复人工全膝关节置换术髌腱断裂三例. 中国修复重建外科杂志, 2020, 34(90): 1002-1892.
32. 高东, 郑江, 张宪, 等. 锚钉修复联合半腱肌转移治疗陈旧性髌腱断裂. 中国矫形外科杂志, 2020, (28): 1005-8478.
33. Pérez-García A, Esteban-Vico JR, García-Sánchez JM. Autologous patellar tendon reconstruction after total knee arthroplasty infection with skin loss: Anatomical study and case report. J Knee Surg, 2020, 332(2): 1538-8506.
34. Crossett LS, Sinha RK, Sechriest VF, et al. Reconstruction of a ruptured patellar tendon with achilles tendon allograft following total knee arthroplasty. J Bone Joint Surg (Am), 2002, 84(8): 1354-1361.
35. Lamberti A, Balato G, Summa PP, et al. Surgical options for chronic patellar tendon rupture in total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc, 2018, 26(5): 1429-1435.
36. Ortiguera CJ, Berry DJ. Patellar fracture after total knee arthroplasty. J Bone Joint Surg (Am), 2002, 84(4): 532-540.
37. Deren ME, Pannu TS, Villa JM, et al. Meta-analysis comparing allograft to synthetic reconstruction for extensor mechanism disruption after total knee arthroplasty. J Knee Surg, 2019. doi: 10.1055/s-0039-1696656.
38. Shau D, Patton R, Patel S, et al. Synthetic mesh vs. allograft extensor mechanism reconstruction in total knee arthroplasty-A systematic review of the literature and meta-analysis. Knee, 2018, 25(1): 2-7.
39. Parker DA, Dunbar MJ, Rorabeck CH. Extensor mechanism failure associated with total knee arthroplasty: prevention and management. J Am Acad Orthop Surg, 2003, 11(4): 238-247.
40. Tria AJ, Harwood DA, Alicea JA, et al. Patellar fractures in posterior stabilized knee arthroplasties. Clin Orthop Relat Res, 1994, (299): 131-138.
41. Scott RD, Turoff N, Ewald FC. Stress fracture of the patella following duopatellar total knee arthroplasty with patellar resurfacing. Clin Orthop Relat Res, 1982, (170): 147-151.
42. Adigweme OO, Sassoon AA, Langford J, et al. Periprosthetic patellar fractures. J Knee Surg, 2013, 26(5): 313-317.
43. Keating EM, Haas G, Meding JB. Patella fracture after post total knee replacements. Clin Orthop Relat Res, 2003, (416): 93-97.
44. 赵学寨, 孟彩云, 刘明辉, 等. 氨甲环酸不同用药方案对同期双侧全膝关节置换术围术期患者出血及术后并发症的影响. 中国药房, 2017, 28(18): 2486-2489.

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