Patellar Tendon Rupture Following Total Knee Arthroplasty
Steven T. Heer1, James O’Dowd2, Rebecca R. Butler3, David O. Dewitt4, Gaurav Khanna4, Raffy Mirzayan4, *
1 Tulane School of Medicine, New Orleans, LA, USA
2 Department of Orthopaedic Surgery, USC Keck School of Medicine, Los Angeles, CA, USA
3 Department of Research and Evaluation, Kaiser Permanente, Pasadena, CA, USA
4 Department of Orthopaedic Surgery, Kaiser Permanente Southern California, Baldwin Park, CA, USA
Patellar tendon rupture following Total Knee Arthroplasty (TKA) is rare. There is no consensus on optimal treatment.
All patients who underwent a primary repair of a traumatic patellar tendon rupture following a TKA between 2008 and 2016, were retrospectively reviewed. Patient information, implant, repair type (anchor vs. bone tunnel), graft use, and complications were recorded.
Twenty-six patients met our inclusion criteria. The average age was 69.7+11 years. There were 19 females (73.1%). The average time from TKA to PT rupture was 13.6 months (range: 0- 135 months). The average incidence was 62.32 per 100,000 TKA. PT was repaired with anchors (A) in 9 (4 with a graft) and trans-osseous tunnels (TO) in 12 (5 required graft), and 5 with other methods. There was a significant improvement in KSS from 61 to 83 (P=0.023). There was a significant difference in time from PT tear to surgery in patients with grafts (42 days) and those without grafts (6 days) (P<0.001). Compared to A repair, TO had 2.39 times odds of re-tear (95% CI: 0.38,15.4; P=0.354) and 1.37 times odds of infection (95% CI:0.074,25.6; P=0.83). Repairs with a graft had a 1.90 times odds of re-tear (95% CI: 0.29, 12.19; P=0.49) and 6.3 time odds of infection (95% CI 0.26, 166.7; P=0.25).
Surgical repair of PT tears following TKA leads to significant clinical improvement, regardless of the fixation method or graft use. We found no difference in outcomes between A and TO repairs and or with graft use.
Keywords: Total knee arthroplasty, Patellar tendon rupture, Anchor, Bone tunnel, Retrospectively, Fixation method.
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