RESEARCH ARTICLE


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


Article Metrics

CrossRef Citations:
0
Total Statistics:

Full-Text HTML Views: 4387
Abstract HTML Views: 502
PDF Downloads: 283
ePub Downloads: 225
Total Views/Downloads: 5397
Unique Statistics:

Full-Text HTML Views: 2592
Abstract HTML Views: 328
PDF Downloads: 230
ePub Downloads: 178
Total Views/Downloads: 3328



Creative Commons License
© 2019 Heer et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Orthopaedic Surgery, Kaiser Permanente Southern California, Baldwin Park, CA, USA; E-mails: lakersdoc@gmail.com, raffy.mirzayan@kp.org


Abstract

Background:

Patellar tendon rupture following Total Knee Arthroplasty (TKA) is rare. There is no consensus on optimal treatment.

Methods:

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.

Results:

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).

Conclusion:

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.