39.
Outcome of allograft reconstruction of the knee extensor mechanism.
Bjarne Mygind-Klavsen, Svend Erik Christiansen, Claus Fink Jepsen, Frank
Madsen, Anders Odgaard, Martin Lind
Division of Sports Trauma, Department of Orthoped Aarhus University
Hospital; Division of Sports Trauma, Department of Orthopedic Surgery,
Aarhus University Hospital; Division of Knee Surgery, Department of
Orthopedic Surgery, Aarhus University Hospital; Division of Knee Surgery,
Department of Orthopedic Surgery, Aarhus University Hospital; Division of
Knee Surgery, Department of Orthopedic Surgery, Aarhus University
Hospital; Division of Sports Trauma, Department of Orthoped, Aarhus
University Hospital
Background:
Knee extensor mechanism defects are seen as a complication
after TKA, Quadriceps tendon ruptures and comminuted patella fractures.
Knee extensor mechanism defects treatment options are limited. One method is
allogenic transplantation of quadriceps tendon, patella, patella tendon and
tibial tubercle.
Purpose / Aim of Study:
The purpose of this study is to describe clinical
outcome in a cohort of patients treated with reconstruction of the knee extensor
mechanism using allograft tissue.
Materials and Methods:
Nine patients treated with reconstruction of the knee
extensor mechanism using allograft tissue from 2008 to 2012 at our
department comprised our study cohort. At project follow-up in 2012, clinical
outcome was evaluated using knee specific scores, objective evaluation of
range of motion and extension force. Function was evaluated by walking and
stair climbing ability.
Findings / Results:
All patients were female and aged from 23 to 89 years.
The average follow up time was 24 months (3-46 months). Five patients had
extensor mechanism defects as a complication to total knee arthroplasty. Three
patients due to comminuted patella fractures. One patient due to other reasons.
The mean extension deficit was < 10
∘
and mean extension force was 4 (3-5).
There were no major complications. The reported walking distance varied
from below 1000m to 3000m without the use of walking aids. The average
KOOS ADL was 52 (35-85). The patients were overall very satisfied with the
procedure.
Conclusions:
The clinical outcome in the present case series of patients treated
with reconstruction of the knee extensor mechanism using allograft tissue
indicate that extensor mechanism transplantation in most case result in
acceptable walking function and knee range of motion. The procedure appears
safe with no major complications.
