Springer Bryan D, Della Valle Craig J
OrthoCarolina Hip and Knee Center, Charlotte, North Carolina, USA.
J Arthroplasty. 2008 Oct;23(7 Suppl):35-8. doi: 10.1016/j.arth.2008.06.016.
Disruption of the extensor mechanism is an infrequent but catastrophic complication after total knee arthroplasty. Treatment is technically challenging. For patellar tendon ruptures, multiple treatment options having been described with inconsistent results. Allograft tissue may provide the best means to adequately reconstruct the disrupted patellar tendon. Options for allograft reconstruction include an Achilles tendon bone block allograft or a whole extensor mechanism allograft. Important surgical principals include rigid fixation of the host allograft junction, coverage of the allograft tissue with as much autogenous tissue as possible to reduce the risk of infection, tensioning the graft in full extension, and not testing the completed repair is crucial. Current results with proper surgical technique show acceptable functional outcome for this devastating complication.
伸肌机制断裂是全膝关节置换术后一种罕见但灾难性的并发症。治疗在技术上具有挑战性。对于髌腱断裂，已有多种治疗方案被描述，但结果并不一致。同种异体移植组织可能是充分重建断裂髌腱的最佳方法。同种异体移植重建的选择包括跟腱骨块同种异体移植或整个伸肌机制同种异体移植。重要的手术原则包括牢固固定宿主与同种异体移植的结合处，用尽可能多的自体组织覆盖同种异体移植组织以降低感染风险，在完全伸直状态下张紧移植物，并且不测试已完成的修复至关重要。采用适当手术技术的当前结果显示，对于这种严重并发症可获得可接受的功能结果。
