ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2023
Inferior results at long-term follow-up after extensor mechanism allograft reconstruction in septic compared to aseptic revision total knee arthroplasty.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed, 7 citations in OpenAlex.
- Acute Extensor Mechanism Disruption Following Total Knee Arthroplasty: Biologic Augmentation of Direct Repair Utilizing a Semitendinosus and Gracilis Autograft.Arthroplasty today · 2026Article
- Quadriceps tendon autograft with patellar bone block and semitendinosus augmentation demonstrates predictable midterm outcomes for patellar tendon disruption following primary total knee arthroplasty.Journal of experimental orthopaedics · 2026Article
- Big data analysis reveals significant increases in complications, costs, and hospital stay in revision total knee arthroplasty compared to primary TKA.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Article
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5 authors at 2 institutions in 1 country.
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Abstract
purposeExtensor mechanism lesion after total knee arthroplasty (TKA) is a catastrophic complication. Reconstruction with extensor mechanism allograft (EMA) has been described as a sound salvage procedure. Its effectiveness at long term and in septic cases is still under scrutiny. The long-term results of EMA reconstruction for chronic extensor mechanism failures following aseptic and septic revision TKA have been analysed.
methodsFrom the institutional database, 35 patients with a revision TKA (RevTKA) undergoing EMA reconstruction from 2005 to 2015 have been retrospectively identified. A history of periprosthetic joint infection (PJI) was found in 13 (37%) patients. The mean follow-up was 81.2 months (± 34.7, range 3-120). EMA failures were considered for lag more than 20°, Knee Society Score (KSS) less than 60 points, and/or in the case of revision of the allograft.
resultsThe mean KSS improved from 35.9 (± 16.9, range 0-54) to 86.6 (± 10.4, range 54-99) points in the aseptic group (p < 0.001) and from 27.5 (± 11.6, range 10-44) to 79.4 (± 16.3, range 48-94) points in the septic group (p < 0.001). The extensor lag changed from 48.4° (± 14.5, range 30-90) to 4.6° (± 10.8, range 0-50) in the aseptic group (p < 0.001) and from 56.5° (± 20.8, range 30-90) to 6.1° (± 6.8, range 0-20) in the septic group (p < 0.001). The mean postoperative flexion was 105.2° (± 13.2, range 75-130) in the aseptic group and 102.7° (± 12.5, range 80-120) in the septic group (p = 0.32). Three failures (14% of the cases) occurred in the aseptic group and five in the septic group (38% of the cases). The overall survivorship at 10 years was 83.3% (22 cases, CI
conclusionsEMA reconstruction after extensor mechanism disruptions in TKA is a reliable salvage procedure. The septic nature of the revision decreased the functionality of the knee joint after EMA, but it did not represent a risk factor for re-ruptures or recurrence of infection. LEVEL OF EVIDENCE: Level III.
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