A rare knee extensor mechanism injury: Vastus intermedius tendon rupture

Acute rupture of the knee extensor mechanism after patellectomy is extremely rare. We present the case of a patient with acute patellar tendon rupture who had undergone patellectomy 53 years before. Twelve days after the injury, the ruptured patellar tendon was repaired with end-to-end suture. Postoperatively, we splinted the knee for 6 weeks but permitted the patient to walk without limiting weight bearing at 1 week postoperatively. At one-year follow-up, the patient is able to move his knee almost full range of motion and the Lysholm knee score is 81. The patient is satisfied with the outcome. This is the first report to treat acute rupture of the patellar tendon in a patient who had undergone patellectomy. Although careful rehabilitation is required, end-to-end suture might be an adequate surgical procedure for acute rupture of the knee extensor mechanism after patellectomy.

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MOMENT ARM OF THE KNEE-EXTENSOR MECHANISM MEASURED IN VIVO ACROSS A RANGE OF DAILY ACTIVITIES

Journal of Biomechanics ◽

10.1016/j.jbiomech.2021.110484 ◽

2021 ◽

pp. 110484

Author(s):

Hans A. Gray ◽

Shanyuanye Guan ◽

Lucas T. Thomeer ◽

Marcus G. Pandy

Keyword(s):

Knee Extensor ◽

Extensor Mechanism ◽

Daily Activities ◽

Moment Arm ◽

Knee Extensor Mechanism

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Iliotibial Band Autograft Provides the Fastest Recovery of Knee Extensor Mechanism Function in Pediatric Anterior Cruciate Ligament Reconstruction

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18147492 ◽

2021 ◽

Vol 18 (14) ◽

pp. 7492

Author(s):

Tishya L. Wren ◽

Veronica Beltran ◽

Mia J. Katzel ◽

Adriana S. Conrad-Forrest ◽

Curtis D. VandenBerg

Keyword(s):

Knee Flexion ◽

Ligament Reconstruction ◽

Cruciate Ligament ◽

Knee Extensor ◽

Extensor Mechanism ◽

Iliotibial Band ◽

Cruciate Ligament Reconstruction ◽

Mechanism Function ◽

Anterior Cruciate ◽

Knee Extensor Mechanism

Iliotibial band autograft is an increasingly popular option for pediatric anterior cruciate ligament reconstruction (ACLR). The purpose of this study was to compare recovery of knee extensor mechanism function among pediatric patients who underwent ACLR using iliotibial band (IT), hamstring tendon (HT), quadriceps tendon (QT), and patellar tendon (PT) autografts. One hundred forty-five pediatric athletes (76 female; age 15.0, range 7–21 years) with recent (3–18 months) unilateral ACLR performed drop-jump landing and 45° cutting with 3D motion capture. Knee extensor mechanism function (maximum knee flexion angle, maximum internal knee extensor moment, energy absorption at knee) during the loading phase (foot contact to peak knee flexion) was compared among graft types (20 IT, 29 HT, 39 QT, 57 PT) and sides (ACLR or contralateral) using linear mixed models with sex, age, and time since surgery as covariates. Overall, knee flexion was significantly lower on the operated vs. contralateral side for HT, QT, and PT during both tasks (p < 0.03). All graft types exhibited lower knee extensor moments and energy absorption on the operated side during both movements (p ≤ 0.001). Kinetic asymmetry was significantly lower for IT compared with QT and PT during both movements (p ≤ 0.005), and similar patterns were observed for HT vs. QT and PT (p ≤ 0.07). Asymmetry was similar between IT and HT and between QT and PT. This study found that knee extensor mechanism function recovers fastest in pediatric ACLR patients with IT autografts, followed by HT, in comparison to QT and PT, suggesting that IT is a viable option for returning young athletes to play after ACLR.

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Comparison of adverse events and postoperative mobilization following knee extensor mechanism rupture repair: A systematic review and network meta-analysis

Injury ◽

10.1016/j.injury.2017.10.013 ◽

2017 ◽

Vol 48 (12) ◽

pp. 2793-2799 ◽

Cited By ~ 7

Author(s):

Joseph Serino ◽

Amin Mohamadi ◽

Sebastian Orman ◽

Brian McCormick ◽

Philip Hanna ◽

...

Keyword(s):

Systematic Review ◽

Adverse Events ◽

Meta Analysis ◽

Knee Extensor ◽

Extensor Mechanism ◽

Knee Extensor Mechanism

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Quadriceps reconstruction with suture anchor and Achilles allograft combination in quadriceps tendon re-rupture after primary surgical repair: A novel technique

Joint Diseases and Related Surgery ◽

10.52312/jdrs.2021.14 ◽

2021 ◽

Author(s):

Erhan Okay ◽

Mehmet Cenk Turgut ◽

Abbas Tokyay

Keyword(s):

Suture Anchor ◽

Surgical Repair ◽

Primary Repair ◽

Full Range ◽

Knee Extensor ◽

Quadriceps Tendon ◽

Extensor Mechanism ◽

Surgical Options ◽

Knee Extensor Mechanism

Quadriceps ruptures are one of the pathological conditions of the knee extensor mechanism, accounting for 3% of all tendon injuries. These injuries cause substantial disability of the extensor mechanism. Primary repair is the treatment of choice in acute presentation. In the setting of chronic conditions, the treatment becomes more challenging. Available surgical options include lengthening procedures, and reconstruction with auto graft or allografts. The traditional Scuderi and Codivilla techniques are challenging to perform in degenerative or traumatic retracted ruptures. There is no standard effective treatment in these patients, which yields the best clinical and biomechanical outcomes. An 18 - year-old male patient with quadriceps re-rupture after a primary repair was managed with allograft reconstruction using suture anchors. At six years of follow-up, the patient gained a full range of motion with excellent clinical outcomes. He returned to his previous work. In conclusion, quadriceps reconstruction using suture anchor and Achilles allograft combination is a feasible technique in neglected cases who present with quadriceps tendon re-rupture after primary surgical repair.

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