SynthesisArchives of orthopaedic and trauma surgery2025
Extensor mechanism disruption following primary and revision total knee arthroplasty: a systematic review and meta-analysis.
Synthesis in Archives of orthopaedic and trauma surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
3 citing papers in PubMed.
- Acute Extensor Mechanism Disruption Following Total Knee Arthroplasty: Biologic Augmentation of Direct Repair Utilizing a Semitendinosus and Gracilis Autograft.Arthroplasty today · 2026Article
- Review
- 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
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundExtensor mechanism disruption (EMD) following total knee arthroplasty (TKA) is a rare but debilitating complication, with an incidence ranging from 0.1 to 2.5%. This condition requires surgical management, either by direct repair or reconstruction using various graft options. Existing literature reports inconsistent outcomes and high complication rates.
methodsA comprehensive search of MEDLINE and Cochrane database (1990-2024) identified studies on EMD management. Studies of Evidence Levels I-IV with a minimum 6 months follow-up, and clear reporting of interventions for EMD were analysed. Data extraction focused on patient demographics, treatment options, and outcomes such as failure rates, complications, extensor lag, range of motion, and ambulation status. Quality appraisal was conducted using the Joanna Briggs Institute (JBI) checklist for non-randomized studies.
resultsA total of 32 studies (655 reconstruction cases, 119 repair cases) were included. Reconstruction options using allografts and synthetic mesh showed comparable failure rates (~ 32%). Direct repairs of quadriceps and patellar tendons demonstrated a failure rate of 33.9% and 63% respectively. Autograft reconstruction options reported no failures but were underrepresented. Extensor lag varied across groups, with autografts demonstrating the least extensor lag (5°). Ambulation status improved postoperatively in successful cases. Complications such as periprosthetic joint infections (PJI) were prevalent in failed cases (39-44%).
conclusionEMD after TKA, managed with reconstruction using allografts or synthetic mesh yielded similar outcomes. Autografts and medial gastrocnemius flaps showed better outcomes in a limited cohort. Larger prospective studies, are needed to address the heterogeneity in outcomes and reporting. LEVEL OF EVIDENCE: Level IV.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.