Patella cryo-free technique with recycled frozen autograft reconstruction preserves extensor mechanism for proximal tibial malignancy

Background: Extensor mechanism injuries involving the quadriceps tendon, patella, or patellar tendon can be a devastating setback for athletes. Despite the potential severity and relative frequency with which these injuries occur, large-scale epidemiological data on collegiate-level athletes are lacking. Study Design: Descriptive epidemiology study. Level of Evidence: Level 4. Methods: Knee extensor mechanism injuries across 16 sports among National Collegiate Athletic Association (NCAA) men and women during the 2004-2005 to 2013-2014 academic years were analyzed using the NCAA Injury Surveillance Program (NCAA-ISP). Extensor mechanism injuries per 100,000 athlete-exposures (AEs), operative rate, annual injury and reinjury rates, in-season status (pre-/regular/postseason), and time lost were compiled and calculated. Results: A total of 11,778,265 AEs were identified and included in the study. Overall, 1,748 extensor mechanism injuries were identified, with an injury rate (IR) of 14.84 (per 100,000 AEs). N = 114 (6.5%) injuries were classified as severe injuries with a relatively higher median time loss (44 days) and operative risk (18.42%). Male athletes had higher risk of season-ending injuries in both all (3.20% vs 0.89%, P < 0.01) and severe (41.54% vs 16.33%, P < 0.01) extensor mechanism injuries. Similarly, contact injuries were more frequently season-ending injuries (4.44% vs 1.69%, P = 0.01). Women’s soccer (IR = 2.59), women’s field hockey (IR = 2.15), and women’s cross country (IR = 2.14) were the sports with the highest rate of severe extensor mechanism injuries. Conclusion: Extensor mechanism injuries in collegiate athletes represent a significant set of injuries both in terms of volume and potentially to their athletic careers. Male athletes and contact injuries appear to have a greater risk of severe injuries. Injuries defined as severe had a higher risk of operative intervention and greater amount of missed playing time. Clinical Relevance: Knowledge of the epidemiology of extensor mechanism injuries may help clinicians guide their athlete patients in sports-related injury prevention and management.

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New variant of bipartite patella with traumatic separation and complete disruption of the extensor mechanism of the knee

BMJ Case Reports ◽

10.1136/bcr-2020-236773 ◽

2021 ◽

Vol 14 (1) ◽

pp. e236773

Author(s):

Kiran Kumar Naikoti ◽

Raghuram Thonse

Keyword(s):

Functional Recovery ◽

Tendon Rupture ◽

Case Reports ◽

Quadriceps Tendon ◽

Extensor Mechanism ◽

Quadriceps Tendon Rupture ◽

Bipartite Patella ◽

New Variant ◽

Complete Disruption ◽

Type 3

Very few case reports have been reported on traumatic separation of the bipartite patella along with quadriceps tendon rupture. These reports relate to separation of superolateral bipartite patella (Saupe type 3). We describe a new variant which to our knowledge has not been described or classified so far, which is purely a superior bipartite patella with traumatic separation and complete functional disruption of the extensor mechanism of the knee in a young patient working in the army which was managed with open reduction and internal fixation along with repair of the extensor mechanism of the knee achieving complete functional recovery.

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INJURIES OF THE DORSAL EXTENSOR MECHANISM OF THE FINGERS

The Medical Journal of Australia ◽

10.5694/j.1326-5377.1970.tb49945.x ◽

1970 ◽

Vol 2 (5) ◽

pp. 213-217 ◽

Cited By ~ 3

Author(s):

T. King

Keyword(s):

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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