Soong J W, Silva A N, Andrew Tan Hc
1 Singapore General Hospital, Singapore, Singapore.
J Orthop Surg (Hong Kong). 2017 May-Aug;25(2):2309499017717206. doi: 10.1177/2309499017717206.
Quadriceps tendon rupture after total knee arthroplasty (TKA) is a rare but dire complication. It is associated with adverse outcomes and morbidities. Studies on such complications are scarce in the literature. In this study, we share our experience in the management of four patients who sustained quadriceps tendon rupture in the early postoperative period. Efforts should be focused on prevention. Meticulous surgical techniques during the medial parapatellar approach to preserve the integrity of quadriceps can reduce the risk of rupture. The importance of prompt diagnosis is emphasized as delayed treatment may lead to poor outcomes. However, making a diagnosis can be challenging, as worsening of the quadriceps strength after TKA is expected because of the surgical approach that violates the quadriceps muscle. In an event of postoperative trauma with resultant extensor weakness, an ultrasound evaluation to exclude a quadriceps tendon rupture should be promptly performed after a fracture is excluded.
全膝关节置换术（TKA）后股四头肌肌腱断裂是一种罕见但严重的并发症。它与不良后果和发病率相关。文献中关于此类并发症的研究很少。在本研究中，我们分享了我们对4例术后早期发生股四头肌肌腱断裂患者的治疗经验。应将努力重点放在预防上。在内侧髌旁入路时采用细致的手术技术以保持股四头肌的完整性可降低断裂风险。强调及时诊断的重要性，因为延迟治疗可能导致不良后果。然而，做出诊断可能具有挑战性，因为由于手术入路侵犯了股四头肌，TKA后股四头肌力量会恶化是预期的。如果术后发生创伤并导致伸肌无力，在排除骨折后应立即进行超声评估以排除股四头肌肌腱断裂。
