Leciejewski Maciej, Królikowska Aleksandra, Reichert Paweł
Department of Trauma and Orthopedic Surgery, District Hospital, Puszczykowo, Poland.
College of Physiotherapy, Wroclaw, Poland.
Polim Med. 2018 Jan-Jun;48(1):53-56. doi: 10.17219/pim/102977.
Quadriceps tendon rupture is a severe and demanding problem in knee surgery, especially when it is recurrent and when elderly patients are involved. It can have a devastating impact when it is a complication following knee arthroplasty. There are many procedures for dealing with this problem, but none of them offer reliable results. The most popular methods of treatment are traditional transosseous sutures and suture anchors, often in combination with semitendinosus augmentation. In cases of osteoporotic bone or hamstring insufficiency, these solutions are not appropriate. One way to manage quadriceps tendon rupture is to use polyethylene terephthalate tape (poly tape) as scaffolding for tissue ingrowth. Because of its structure, poly tape provides adequate strength and allows early mobilization. Besides being durable, multifilament high tenacity polyethylene terephthalate is flexible. Poly tape augmentation is particularly recommended in the following cases: recurrent rupture of the quadriceps tendon; extensor apparatus damage following total knee arthroplasty (TKA); delayed diagnosis of quadriceps tendon rupture; and in elderly patients (with weak bones and poor ligament quality). The surgical technique is simple and the procedure has a low complication rate. There have been many studies confirming the security of polyethylene terephthalate use in the human body. There is also a great deal of evidence concerning tissue ingrowth in the mesh structure of poly tape. Allergic reactions and inflammatory responses are rare.
股四头肌肌腱断裂是膝关节手术中一个严重且棘手的问题,尤其是在复发性断裂以及涉及老年患者时。当它作为膝关节置换术后的并发症出现时,可能会产生毁灭性的影响。处理这个问题有很多方法,但没有一种能提供可靠的结果。最常用的治疗方法是传统的经骨缝合和缝合锚钉,通常还会结合半腱肌增强术。在骨质疏松性骨或腘绳肌功能不全的情况下,这些解决方案并不合适。处理股四头肌肌腱断裂的一种方法是使用聚对苯二甲酸乙二酯带(聚酯带)作为组织向内生长的支架。由于其结构,聚酯带提供了足够的强度并允许早期活动。除了耐用外,复丝高韧性聚对苯二甲酸乙二酯还很灵活。聚酯带增强术特别推荐用于以下情况:股四头肌肌腱复发性断裂;全膝关节置换术(TKA)后伸肌装置损伤;股四头肌肌腱断裂的延迟诊断;以及老年患者(骨骼脆弱且韧带质量差)。手术技术简单,该手术并发症发生率低。有许多研究证实了聚对苯二甲酸乙二酯在人体使用的安全性。也有大量证据表明聚酯带的网状结构中有组织向内生长。过敏反应和炎症反应很少见。