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Review
. 2021 Mar 1;6(3):181-188.
doi: 10.1302/2058-5241.6.200119. eCollection 2021 Mar.

Extensor mechanism failure in total knee arthroplasty

Jimmy Ng  1 , Pau Balcells-Nolla  1 , Peter J James  1 , Benjamin V Bloch  1
Affiliations
Review

Extensor mechanism failure in total knee arthroplasty

Jimmy Ng et al. EFORT Open Rev. .

Abstract

Extensor mechanism failure in total knee arthroplasty (TKA) can present as quadriceps tendon rupture, patella fracture or patella tendon rupture.Component malrotation, excessive joint line elevation and previous lateral release are some of the risk factors contributing to extensor mechanism failure in TKA.Partial quadriceps tendon rupture and undisplaced patella fracture with intact extensor mechanism function can be treated conservatively.Extensor mechanism failure in TKA with disruption of the extensor mechanism function should be treated operatively as it is associated with poor function and extensor lag.It is recommended that acute repair of patella or quadriceps tendon rupture are augmented due to the high risk of re-rupture.Chronic ruptures of the extensor mechanism must be reconstructed as repair has a high failure rate. Reconstruction can be performed using autograft, allograft or synthetic graft. Cite this article: EFORT Open Rev 2021;6:181-188. DOI: 10.1302/2058-5241.6.200119.

Keywords: patella fracture in total knee arthroplasty; patella tendon rupture in total knee arthroplasty; quadriceps tendon rupture in total knee arthroplasty.

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Conflict of interest statement

ICMJE Conflict of interest statement: PJJ reports an educational contract with DePuy Synthes and receives royalties and consultancy fees from DePuy Synthes, outside the submitted work. BVB reports an educational contract with DePuy Synthes and has received speaker fees, outside the submitted work. The other authors declare no conflict of interest relevant to this work.

Figures

Fig. 1
Fig. 1
Patella fracture after total knee arthroplasty.
Fig. 2
Fig. 2
Patella tendon rupture after total knee arthroplasty.
Fig. 3
Fig. 3
Management of patella tendon rupture after total knee arthroplasty.
Fig. 4
Fig. 4
Management of patella fracture after total knee arthroplasty (TKA).
Fig. 5
Fig. 5
Management of quadriceps tendon rupture after total knee arthroplasty.
Fig. 6
Fig. 6
Radiograph showing pre and postoperative reconstruction using extensor mechanism (EM) allograft.
See this image and copyright information in PMC

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