• Full Name: ADRIAN BARRERA FLORES
• Affiliation/Institution: Clinica Cemtro
• Country: Spain

Objectives

There are limited published reports on outcomes of reconstruction of failed extensor mechanism. This study thus serves to report on one institution's experience of extensor mechanism reconstruction over a 10-year period.

Materials and Methods

Consecutive patients with a previous total knee arthroplasty undergoing extensor mechanism reconstruction using a fresh-frozen EMA tensioned in full extension were identified retrospectively from single-center institutional database (N = 18 patients, 18 knees; mean follow-up 10 years [abril 2013- may 2023]).

Results

14 patients (8 women and 6 men) , 58.9 a Age (36-76a), Range pre-surgical mobility flexo -5o-30o flexión 10o-110o, Range post-surgical mobility 0o - 5o flexion 20o-120o. Three reconstructions (28,6%) were considered failures considered clinical failures secondary to Knee Society score of <60 points or an extensor lag of> 30o. The mean Knee Society score improved from 32 to 70 points (p <0.0001). seven patients required component replacement (50%), five patients required arthroscopic reintervention for arthrofibrosis. we do not have any deep infection.With a survival of 71,4% at 10 years.

Conclusions

Our results after five years of experience on the reconstruction of the extensor mechanism in TKA reflect the difficult scenario that both the patient and the surgeon face after this catastrophic complication, EMA reconstruction provides adequate survivorship at intermediate-term follow-up after TKA; however, reoperation rates are high and appropriate patient counseling about the possibility of complications is necessary.