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Órgano Oficial de Difusión Científica de la Federación Mexicana de Colegios de Ortopedia y Traumatología, A.C. (FEMECOT)

2018, Number 3

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Ortho-tips 2018; 14 (3)

Rupture of the extensor mechanism in total knee arthroplasty

Salazar LJN

Language: Spanish
References: 18
Page: 140-146
PDF size: 152.63 Kb.


ABSTRACT

The defect at any level of the knee extension mechanism produces a disabling functional consequence, not to mention that when the rupture of the extensor mechanism occurs after total knee arthroplasty, the treatment is difficult because it negatively affects the survival of the implant and the outcome of the patient. The risk factors for this injury are previous surgery, extensive surgical release, use of local corticosteroids, diabetes, obesity, microtrauma, inflammatory disease, use of quinolines and inadequate positioning of prosthetic components. The failure of the extension mechanism may be infrapatelar, transpatelar or suprapatelar. When the problem is transpatellar with stable implant or infrapatellar and suprapatellar in patients with partial or low injury, conservative treatment may be indicated. If surgical treatment is necessary, it is suggested to avoid primary repair and the use of autograft in case of chronic lesions, recommending reconstruction with autograft, allograft or synthetic material (polypropylene mesh). The probability of success of a primary repair is ‹ 10%.


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