Reconstructing the chronically disrupted knee extensor mechanism after total knee arthroplasty: Hourglass variant of the original partial allograft technique

Orthop Traumatol Surg Res. 2017 Dec;103(8):1197-1200. doi: 10.1016/j.otsr.2017.07.001. Epub 2017 Jul 18.

Abstract

Allograft reconstruction is a valuable treatment option for patients with chronic extensor mechanism disruption after total knee arthroplasty. Here, an hourglass variant of the original partial allograft technique is described. An hourglass-shaped patellar bone block is press-fit into the native patella. The graft is fixed to both the patella and the tibia then sutured with the knee fully extended. Outcomes of this technique were assessed in 5 patients after at least 24months' follow-up. The mean knee and function Knee Society Score values were 77.8 and 64.0, respectively. Extension lag was less than 10 in all 5 patients. This hourglass variant of the partial allograft technique is a useful treatment option that can be used even after patellar resurfacing.

Keywords: Knee extensor mechanism disruption; Partial allograft; Total knee arthroplasty.

MeSH terms

  • Allografts*
  • Arthroplasty, Replacement, Knee / adverse effects*
  • Female
  • Humans
  • Joint Instability / etiology
  • Joint Instability / surgery*
  • Knee Joint / surgery
  • Male
  • Middle Aged
  • Orthopedic Procedures / methods
  • Patella / surgery*
  • Postoperative Complications
  • Tendons / transplantation*
  • Tibia / surgery*