Zanotti R M, Freiberg A A, Matthews L S
Section of Orthopaedic Surgery, University of Michigan Hospitals, Ann Arbor, USA.
J Arthroplasty. 1995 Jun;10(3):271-4. doi: 10.1016/s0883-5403(05)80173-1.
A catastrophic complication after total knee arthroplasty (TKA) is rupture of the patellar tendon. Several techniques for treatment have been described, including cast immobilization with or without operative repair, the use of a semitendinosus, fascia lata, or hamstring tendon autogenous graft, the use of a Dacron 4-mm vascular graft (U.S. Catheter and Instrument, Glen Falls, NY), the use of bovine xenograft and even transplantation of an entire allograft extensor mechanism. Treatment results of patellar tendon rupture after TKA can be discouraging. Altered tissue quality secondary to connective tissue diseases, diabetes, rheumatoid arthritis, lupus erythematosus, secondary hyperparathyroidism, or concurrent steroid medications contributes to poor results. Additionally, no one treatment has provided consistent clinical success. Successful treatment of a patient with a ruptured patellar tendon after TKA using the bone-patellar tendon-bone allograft commonly used for anterior cruciate ligament reconstruction is reported.
全膝关节置换术（TKA）后一种灾难性并发症是髌腱断裂。已经描述了几种治疗技术，包括有或无手术修复的石膏固定、使用半腱肌、阔筋膜张肌或腘绳肌腱自体移植物、使用4毫米涤纶血管移植物（美国导管和器械公司，纽约州格伦斯福尔斯）、使用牛异种移植物甚至移植整个同种异体伸肌机制。TKA后髌腱断裂的治疗结果可能令人沮丧。结缔组织疾病、糖尿病、类风湿性关节炎、红斑狼疮、继发性甲状旁腺功能亢进或同时使用类固醇药物导致的组织质量改变会导致预后不良。此外，没有一种治疗方法能始终取得临床成功。本文报道了一名TKA后髌腱断裂患者使用常用于前交叉韧带重建的骨-髌腱-骨同种异体移植物成功治疗的案例。
