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Comparative Study
. 2020 May 30;91(4-S):146-151.
doi: 10.23750/abm.v91i4-S.9705.

Total knee revision arthroplasty: comparison between tibial tubercle osteotomy and quadriceps snip approach. Complication rate

Paolo Di Benedetto  1 , Michele Buttironi  2 , Piero Giardini  2 , Francesco Mancuso  3 , Vanni Cainero  2 , Araldo Causero  4
Affiliations
Comparative Study

Total knee revision arthroplasty: comparison between tibial tubercle osteotomy and quadriceps snip approach. Complication rate

Paolo Di Benedetto et al. Acta Biomed. .

Abstract

Background and aim of the work: The total knee arthroplasty (TKA) revision is not a second time of primary implant surgery but is a very complex issue for orthopedic surgeon. When local conditions make necessary a greater visualization, medial para-patellar access with quadriceps snip (QS) or the osteotomy of the tibial tuberosity (TTO) can be the solutions. This work aims to compare the quadriceps snip and the detachment of the tibial tubercle, focusing on possible complications.

Materials and methods: At our institution, between January 2017 and February 2019 52 TKA revision for periprosthetic joint infection (PJI) or aseptic mobilization were performed. In 43 cases an extensive surgical approach was required: for patients with range of movement (ROM) < 60° was chosen TTO, while with ROM > 60° a QS was performed. Clinical and radiological follow-up was available for all the 43 cases.

Results: The data about clinical outcome in our study show that both groups have a positive trend in KSS score over time with similar ROM results. Two partial avulsions of patellar tendon during revision surgery were reported. Clinical outcome in both groups has shown good results at the end of follow-up with no post-operative incidence of complications.

Conclusion: We can assert that both QS and TTO are good approach for TKA revision. Future studies will be needed to understand if preparatory ROM is a good way to decide which surgical approach to use.(www.actabiomedica.it).

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Conflict of interest statement

Each author declares that he or she has no commercial associations (e.g. consultancies, stock ownership, equity interest, patent/licensing arrangement etc.) that might pose a conflict of interest in connection with the submitted article

Figures

Figure 1.
Figure 1.
TKA revision with TTO approach and AO laces fixation.
Figure 2.
Figure 2.
TKA revision with TTO approach and screws fixation.
See this image and copyright information in PMC

References

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    1. Di Benedetto P, et al. Two-stage revision after total knee arthroplasty. Acta Biomed. 2017;88(2S):92–97. - PMC - PubMed
    1. Mancuso F, et al. Management of metaphyseal bone loss in revision knee arthroplasty. Acta Biomed. 2017;88(2S):98–111. - PMC - PubMed

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