Abstract
Case Two patients presented with chronic knee extensor mechanism disruption after failed primary repairs. Both patients had minimal ambulatory knee function prior to surgical intervention and were treated with a synthetic mesh reconstruction of their extensor mechanism. Our technique has been modified from previously described techniques used in revision knee arthroplasty. At the one-year follow-up, both patients had improvement in their active range of motion and had returned to their previous activity. Conclusion Synthetic mesh reconstruction of chronic extensor mechanism disruption is a viable technique that can be utilized as salvage for the persistently dysfunctional native knee.
Highlights
Quadriceps tendon (QT) ruptures occur most frequently in middle-aged males [1] and typically can be successfully treated with primary surgical repair [2, 3]
We present two cases of chronic, reruptured QT injuries in native knees treated with synthetic mesh reconstruction
These techniques differ from previously described techniques in knee arthroplasty that relied on intraosseous graft fixation in the tibia for distal fixation [10]
Summary
Quadriceps tendon (QT) ruptures occur most frequently in middle-aged males [1] and typically can be successfully treated with primary surgical repair [2, 3]. While worse surgical outcomes are associated with delays to primary repair, the overall rate of repair failure or rerupture of acute injuries remains low (approximately 2%) [2, 4, 5]. QT injuries are typically repaired with direct tissue apposition, transosseous tunnels, or suture anchors, depending on whether the injury occurs midsubstance or at the osseotendinous interface [2, 4, 5]. Treatment of chronic ruptures or reruptures of prior repairs represents a greater surgical challenge, with no clear gold standard for reconstruction. We present two cases of chronic, reruptured QT injuries in native knees treated with synthetic mesh reconstruction. QT reconstruction using this technique, typically reserved for post total knee arthroplasty (TKA) knees, resulted in favorable outcomes in both patients at the final follow-up
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