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

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.

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

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.

Arthroscopic Posterior Cruciate Ligament Reconstruction: The Achilles Tendon Allograft versus the Quadriceps Tendon Allograft

2019 ◽  
Vol 33 (06) ◽  
pp. 553-559 ◽  
Author(s):  
Seung Hoon Kang ◽  
Kang Min Sohn ◽  
Do Kyung Lee ◽  
Byung Hoon Lee ◽  
Seong Wook Yang ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Cruciate Ligament ◽  
Preoperative Evaluation ◽  
Quadriceps Tendon ◽  
Lysholm Score ◽  
Pcl Reconstruction ◽  
Tendon Allograft ◽  
Subjective Score ◽  
Achilles Tendon Allograft

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.

Extensor Mechanism Reconstruction with Achilles Tendon Allograft in TKA: Results of an Abbreviate Rehabilitation Protocol

2014 ◽  
Vol 29 (6) ◽  
pp. 1211-1215 ◽  
Author(s):  
Claudio Diaz-Ledezma ◽  
Fabio R. Orozco ◽  
Lawrence A. Delasotta ◽  
Paul M. Lichstein ◽  
Zachary D. Post ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Extensor Mechanism ◽  
Rehabilitation Protocol ◽  
Tendon Allograft ◽  
Achilles Tendon Allograft

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

2006 ◽  
Vol 14 (11) ◽  
pp. 1171-1175 ◽  
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

scholarly journals Achilles Tendon Allograft with Semitendinosus Autograft Reinforcement Is a Successful Treatment for Chronic Patellar Tendon Rupture: Report of Two Cases

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Lucie Regennass ◽  
Mathieu Boissard ◽  
Alban Fouasson-Chailloux ◽  
Ronan Guillou ◽  
Cecile Toanen ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Patellar Tendon ◽  
Tendon Rupture ◽  
Surgical Techniques ◽  
Extensor Mechanism ◽  
Reconstruction Technique ◽  
Patellar Tendon Rupture ◽  
Tendon Allograft ◽  
Optimal Approach ◽  
Achilles Tendon Allograft

Rupture of the patellar tendon must be diagnosed urgently because reconstruction of the extensor mechanism produces better results when it is performed in acute conditions. Reconstruction of chronic extensor mechanism rupture on the contrary is very challenging. Several surgical techniques have been described using a variety of graft choices and fixation methods, but the optimal approach is still under debate. We report our experience of two cases of chronic patellar tendon rupture reconstruction using an Achilles tendon allograft reinforced by a vascularized ipsilateral semitendinosus tendon frame. The rapid functional recovery of the range of motion, only three months postoperatively, showed us that this reconstruction technique was effective.

Long-term results of extensor mechanism reconstruction using Achilles tendon allograft after total knee arthroplasty

2018 ◽  
Vol 42 (10) ◽  
pp. 2367-2373 ◽  
Author(s):  
Brent T. Wise ◽  
Greg Erens ◽  
Aidin Eslam Pour ◽  
Thomas L. Bradbury ◽  
James R. Roberson
Keyword(s):  
Total Knee Arthroplasty ◽  
Achilles Tendon ◽  
Knee Arthroplasty ◽  
Extensor Mechanism ◽  
Long Term Results ◽  
Tendon Allograft ◽  
Total Knee ◽  
Achilles Tendon Allograft

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

2019 ◽  
Vol 8 (9) ◽  
pp. e1031-e1036 ◽  
Author(s):  
Kyle N. Kunze ◽  
Robert A. Burnett ◽  
Kevin K. Shinsako ◽  
Charles A. Bush-Joseph ◽  
Brian J. Cole ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Tendon Repair ◽  
Quadriceps Tendon ◽  
Tendon Defect ◽  
Tendon Allograft ◽  
Achilles Tendon Allograft

scholarly journals Synthetic Mesh Reconstruction of Chronic, Native Quadriceps Tendon Disruptions following Failed Primary Repair

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Braden E. Hartline ◽  
Jacob M. Wilson ◽  
Andrew M. Schwartz ◽  
James R. Roberson ◽  
George N. Guild
Keyword(s):  
Primary Repair ◽  
Knee Extensor ◽  
Quadriceps Tendon ◽  
Synthetic Mesh ◽  
Extensor Mechanism ◽  
Active Range Of Motion ◽  
Mesh Reconstruction ◽  
One Year ◽  
The One

Case. Two patients presented with chronic knee extensor mechanism disruption after failed primary repairs. Both patients had minimal ambulatory knee function prior to surgical intervention and were treated with a synthetic mesh reconstruction of their extensor mechanism. Our technique has been modified from previously described techniques used in revision knee arthroplasty. At the one-year follow-up, both patients had improvement in their active range of motion and had returned to their previous activity. Conclusion. Synthetic mesh reconstruction of chronic extensor mechanism disruption is a viable technique that can be utilized as salvage for the persistently dysfunctional native knee.

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