Abstract
Introduction: Rupture of a Quadriceps Tendon (QT) following a Total Knee Arthroplasty (TKA) is a rare complication. The purpose of this study was to report outcomes and complications of QT repair following TKA. Methods: From a cohort of 437 QT repairs, 19 individuals were identified who had previously undergone a TKA on the ipsilateral leg. Data was collected on individuals with a minimum follow up of 3 months post QT repair (n=16), including Knee Society Scores, pre and post-operative lag, and pre and post-operative range of motion. Results: 13 patients were treated with End-to-End (EE) repairs and 6 were treated with transosseous or suture anchor repair (ATO). In the ATO group, there was no difference in pre (68.0 ± 22.5) and post KSS (82 ± 9.16) (p=0.231), but in the EE group, there was a significant improvement in KSS (pre=67.8 ± 13.1, post=86 ± 16.75, p=0.0027). There was significant difference in post-operative extension lag between ATO (26.0 ± 12.6) vs. EE (4.0 ± 2.74) (p=0.0083). Four out of six ATO patients had extension lag ≥10 degree extensor lag (66.7%) compared to 2 out of 13 (15.4%) patients in the EE group. Compared to EE, ATO repair had an 8.00 times odds of re-tear (95% CI: 0.53,120.6; p=0.133) and 2.75 times greater risk of infection (95% CI: 0.284, 26.61; p=0.382). Conclusion: Patients who underwent EE repair had better functional improvements compared to the ATO group and smaller extension lag.
Highlights
Rupture of a Quadriceps Tendon (QT) following a Total Knee Arthroplasty (TKA) is a rare complication
We identified 19 patients who sustained a QT disruption following a total knee arthroplasty
Compared to EE, Anchor or Trans-Osseous repair (ATO) repair had an 8.00 times odds of re-tear and 2.75 times greater risk of infection
Summary
Rupture of a Quadriceps Tendon (QT) following a Total Knee Arthroplasty (TKA) is a rare complication. The purpose of this study was to report outcomes and complications of QT repair following TKA. Rupture of the quadriceps tendon following a total knee arthroplasty (TKA) is relatively uncommon. The incidence of this complication is estimated to be between 0.1% and 1.1% [1, 2]. Attempts to repair the tendon often have poor prognoses leading to lifelong consequences for patients requiring repeat interventions [3, 4]. There are three main techniques for treating these tears, including end-to-end primary repair, suture through bone tunnels, and repairs using suture anchors [5, 6]. Due to the uncommon nature of this event, it is still unclear which of these techniques is superior.
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