Thomas J Wood1, Jennifer Leighton, David J Backstein, Jacquelyn D Marsh, James L Howard, Richard W McCalden, Steven J MacDonald, Brent A Lanting. 1. From the Division of Orthopaedic Surgery, Department of Surgery, London Health Sciences Centre University Campus, University of Western Ontario, London, Ontario, Canada (Dr. Wood, Dr. Howard, Dr. McCalden, Dr. MacDonald, and Dr. Lanting), the Granovsky Gluskin Division of Orthopedic Surgery, Department of Surgery, Mount Sinai Hospital, Toronto, Ontario, Canada (Dr. Leighton and Dr. Backstein), the School of Physical Therapy, Faculty of Health Sciences (Dr. Marsh), Western University, the Bone and Joint Institute (Dr. Marsh, Dr. Howard, Dr. McCalden, Dr. MacDonald, and Dr. Lanting), Western University, London, Ontario, Canada, and the Department of Surgery, Division of Orthopaedic Surgery, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada (Dr. Wood).
Abstract
BACKGROUND: Extensor mechanism disruption after total knee arthroplasty is a serious complication leading to notable patient morbidity. The purpose of this study is to compare the outcomes of extensor mechanism allograft with synthetic graft reconstruction. METHODS: We retrospectively identified all patients who underwent extensor mechanism reconstruction using either allograft or synthetic graft from two high-volume academic arthroplasty institutions between 2006 and 2017. We collected extensor lag, need for ambulatory aids, and patient-reported outcome measures, as well as the incidence of postoperative complications and revision surgeries. We evaluated cost differences, considering both material cost and the need for revision surgery. RESULTS: We identified 27 cases. A significantly greater postoperative extensor lag was found in the allograft group (P = 0.05). Graft failure after synthetic reconstruction was zero, with an overall revision surgery rate of 15%. Graft failure was 21%, and the revision surgery rate was 43% after allograft reconstruction. The allograft cost was significantly higher compared with the synthetic graft cost (P = 0.001). The mean total cost was 4,733.08 CAD for the synthetic group and 24,050.40 CAD for the allograft group (P = 0.17). DISCUSSION: Synthetic reconstruction for extensor mechanism disruption shows benefit in postoperative extensor lag, graft failure, revision surgery, and cost when compared with allograft. LEVEL OF EVIDENCE: Level III.
BACKGROUND: Extensor mechanism disruption after total knee arthroplasty is a serious complication leading to notable patient morbidity. The purpose of this study is to compare the outcomes of extensor mechanism allograft with synthetic graft reconstruction. METHODS: We retrospectively identified all patients who underwent extensor mechanism reconstruction using either allograft or synthetic graft from two high-volume academic arthroplasty institutions between 2006 and 2017. We collected extensor lag, need for ambulatory aids, and patient-reported outcome measures, as well as the incidence of postoperative complications and revision surgeries. We evaluated cost differences, considering both material cost and the need for revision surgery. RESULTS: We identified 27 cases. A significantly greater postoperative extensor lag was found in the allograft group (P = 0.05). Graft failure after synthetic reconstruction was zero, with an overall revision surgery rate of 15%. Graft failure was 21%, and the revision surgery rate was 43% after allograft reconstruction. The allograft cost was significantly higher compared with the synthetic graft cost (P = 0.001). The mean total cost was 4,733.08 CAD for the synthetic group and 24,050.40 CAD for the allograft group (P = 0.17). DISCUSSION: Synthetic reconstruction for extensor mechanism disruption shows benefit in postoperative extensor lag, graft failure, revision surgery, and cost when compared with allograft. LEVEL OF EVIDENCE: Level III.
Authors: Camilo Partezani Helito; Alan de Paula Mozella; Bruno Butturi Varone; Marco Kawamura Demange; Riccardo Gomes Gobbi; Sandra Tie Nishibe Minamoto; Hugo Alexandre de Araujo Barros Cobra Journal: Acta Ortop Bras Date: 2022-07-06 Impact factor: 0.683
Authors: Cristiano De Franco; Vincenzo de Matteo; Marco Lenzi; Ernesto Marano; Enrico Festa; Alessio Bernasconi; Francesco Smeraglia; Giovanni Balato Journal: J Orthop Surg Res Date: 2022-03-09 Impact factor: 2.359