Trapezoidal Achilles Tendon Allograft Plug for Revision Quadriceps Tendon Repair With a Large Tendon Defect

AbstractWe aimed to compare and analyze the outcomes of arthroscopic posterior cruciate ligament (PCL) reconstruction with the Achilles tendon allograft and the quadriceps tendon allograft. Twenty-nine patients who received the same procedure of arthroscopic PCL reconstruction within our inclusion criteria were reviewed retrospectively. There were 13 patients in the Achilles tendon allograft group and 16 patients in the quadriceps tendon allograft group. At least in 2 years of follow-up period, we evaluated the patients using the posterior drawer test, KT 2000 test, Lysholm knee scoring scale, Tegner activity scale score, International Knee Documentation Committee (IKDC) subjective knee form score, and Telos stress radiography. Between the two groups, no differences were found in preoperative patient demographic factors (age, gender, mean time of surgery, average follow-up period, cause of injury, and combined injury) (p > 0.05). Results of the posterior drawer test, KT 2000 test, Telos stress radiography, Lysholm score, Tegner activity score, and IKDC subjective score were not significantly different between the two groups at preoperative evaluation and after surgery (p > 0.05). On comparing preoperative evaluation and follow-up after surgery, the Achilles tendon allograft group showed significant improvement in the results of the KT 2000 test, Telos stress radiology, and Lysholm score, whereas the quadriceps tendon allograft group showed significant improvement in the results of the KT 2000 test, Telos stress radiology, Lysholm score, Tegner activity score, and IKDC subjective score (p < 0.05). The quadriceps tendon for arthroscopic PCL reconstruction is good alternative allograft for the Achilles tendon for arthroscopic PCL reconstruction. This is a retrospective comparative study.

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One-Stage Complex Achilles Tendon Defect Reconstruction with an Achilles Tendon Allograft and a Gracilis Free Flap

Foot & Ankle International ◽

10.3113/fai.2010.0634 ◽

2010 ◽

Vol 31 (7) ◽

pp. 634-638 ◽

Cited By ~ 9

Author(s):

Efstathios G. Lykoudis ◽

George V. Contodimos ◽

Stavros Ristanis ◽

Anastasios D. Georgoulis ◽

Spyros A. Lazarou

Keyword(s):

Achilles Tendon ◽

Free Flap ◽

Defect Reconstruction ◽

One Stage ◽

Tendon Defect ◽

Tendon Allograft ◽

Achilles Tendon Allograft

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Reconstruction of quadriceps tendon with Achilles tendon allograft in older children with congenital dislocation of the knee

Knee Surgery Sports Traumatology Arthroscopy ◽

10.1007/s00167-006-0083-0 ◽

2006 ◽

Vol 14 (11) ◽

pp. 1171-1175 ◽

Cited By ~ 4

Author(s):

Yetkin Söyüncü ◽

Ercan Mıhçı ◽

Haluk Özcanlı ◽

Merter Özenci ◽

Feyyaz Akyıldız ◽

...

Keyword(s):

Achilles Tendon ◽

Quadriceps Tendon ◽

Congenital Dislocation ◽

Older Children ◽

Tendon Allograft ◽

Achilles Tendon Allograft

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A Strategy for Repair, Augmentation, and Reconstruction of Knee Extensor Mechanism Disruption: A Retrospective Review

Orthopaedic Journal of Sports Medicine ◽

10.1177/23259671211046625 ◽

2021 ◽

Vol 9 (10) ◽

pp. 232596712110466

Author(s):

Courtney R. Carlson Strother ◽

Matthew D. LaPrade ◽

Lucas K. Keyt ◽

Ryan R. Wilbur ◽

Aaron J. Krych ◽

...

Keyword(s):

Achilles Tendon ◽

Primary Repair ◽

Knee Extensor ◽

Quadriceps Tendon ◽

Semitendinosus Tendon ◽

Extensor Mechanism ◽

Tissue Quality ◽

Tendon Allograft ◽

Tendon Autograft ◽

Achilles Tendon Allograft

Background: The loss of extensor mechanism continuity that occurs with patellar and quadriceps tendon rupture has devastating consequences on patient function. Purpose: To describe a treatment strategy for extensor mechanism disruption and evaluate the outcomes of 3 techniques: primary repair, repair with semitendinosus tendon autograft augmentation, and reconstruction with Achilles tendon allograft. Study Design: Case series; Level of evidence, 4. Methods: The authors reviewed surgeries for extensor mechanism disruption performed by a single surgeon between 1999 and 2019. Patient characteristics, imaging studies, surgical techniques, and outcomes were recorded. Primary ruptures with robust tissue quality were repaired primarily, and first-time ruptures with significant tendinosis or moderate tissue loss were repaired using quadrupled semitendinosus tendon autograft augmentation. Patients with failed previous extensor mechanism repair or reconstruction and poor tissue quality underwent reconstruction with Achilles tendon allograft. The primary outcome was extensor mechanism integrity at a minimum 1-year follow-up, with extensor mechanism lag defined as >5° loss of terminal, active knee extension. Secondary outcomes included postoperative knee range of motion, International Knee Documentation Committee (IKDC) and Tegner activity scores, and the radiographic Caton-Deschamps Index. Results: Included were 22 patellar tendon and 21 quadriceps tendon surgeries (patients: 82.5% male; mean age, 48.1 years; body mass index, 31). Seventeen (39.5%) cases underwent primary tendon repair, 13 (30.2%) had repair using semitendinosus tendon autograft augmentation, and 13 (30.2%) underwent reconstruction using an Achilles tendon allograft. Seventeen (39.5%) cases had at least 1 prior failed extensor mechanism surgery performed at an outside facility. At the last follow-up, 4 (9.3%) cases had an extensor mechanism lag, no cases required additional extensor mechanism surgery, and all cases were able to achieve >90° of knee flexion. Postoperative IKDC scores were significantly improved with all methods of extensor mechanism surgery, and postoperative Tegner activity scores were significantly improved in patients who underwent primary repair and Achilles tendon allograft reconstruction ( P < .05 for all). Conclusion: Primary repair alone, repair using quadrupled semitendinosus tendon autograft augmentation, and reconstruction using Achilles tendon allograft were all effective methods to restore extensor mechanism and knee function with the proper indications. Persistent knee extensor lag was more common in chronic extensor mechanism injuries after failed surgery, although patients still reported significantly improved postoperative functional outcomes.

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