Ormaza Amaia, Moreta Jesús, Mosquera Javier, de Ugarte Oskar Sáez, Mozos José Luis Martinez-de Los
Orthopedics. 2017 Jan 1;40(1):38-42. doi: 10.3928/01477447-20160915-02. Epub 2016 Sep 21.
Tear of the quadriceps tendon after revision or primary total knee arthroplasty is a rare complication, but when it occurs, this injury has serious functional consequences. In complete tears, the outcome of direct repair is unpredictable, and several authors recommend that the suture should be reinforced. Several techniques have been described, including the use of autografts, allografts, and synthetic mesh. The goal of this study was to assess the outcomes of a reconstruction technique augmented with synthetic mesh. A retrospective study was performed involving 3 patients who had chronic partial quadriceps tendon tear after total knee revision. In 2 cases, proximal quadriceps release was performed. When conservative management failed, surgical reconstruction with suture reinforced with synthetic mesh was attempted. The knee was immobilized in full extension for 6 weeks after the surgical procedure. A minimum follow-up of 12 months was required to assess results. All reconstructions showed clinical success at a mean follow-up of 19 months. Mean Knee Society Score improved from 55.7 to 87.3, with average postoperative extensor lag of 3.3° (range, 0°-10°). The mean visual analog scale pain score was 2.3 (range, 0-4). No complications were reported. Synthetic mesh has previously been shown to be an effective treatment for patellar tendon repairs after total knee replacement, but there have been few articles on quadriceps rupture. Surgical reconstruction with synthetic mesh is a viable option that provides good functional outcomes in chronic quadriceps tendon rupture after total knee arthroplasty. [Orthopedics. 2017; 40(1):38-42.].
翻修或初次全膝关节置换术后股四头肌肌腱撕裂是一种罕见的并发症，但一旦发生，这种损伤会产生严重的功能后果。在完全撕裂的情况下，直接修复的结果不可预测，一些作者建议应加强缝合。已经描述了几种技术，包括使用自体移植物、同种异体移植物和合成网片。本研究的目的是评估一种用合成网片增强的重建技术的效果。进行了一项回顾性研究，纳入了3例全膝关节翻修术后慢性股四头肌肌腱部分撕裂的患者。其中2例进行了股四头肌近端松解。当保守治疗失败时，尝试用合成网片加强缝合进行手术重建。术后膝关节伸直位固定6周。需要至少12个月的随访来评估结果。所有重建在平均19个月的随访时均显示临床成功。膝关节协会平均评分从55.7提高到87.3，术后平均伸膝滞后3.3°（范围0°-10°）。视觉模拟量表疼痛评分平均为2.3（范围0-4）。未报告并发症。合成网片先前已被证明是全膝关节置换术后髌腱修复的有效治疗方法，但关于股四头肌断裂的文章很少。用合成网片进行手术重建是一种可行的选择，在全膝关节置换术后慢性股四头肌肌腱断裂中能提供良好的功能结果。[《骨科》。2017年；40(1):38-42。]
