Abstract

ARCANGELO, Joana; FIGUEIRA, Paulo; GRENHO, André  and  GOMES, Jorge. Aloenxerto de tendão de Aquiles no tratamento de rotura crónica do tendão rotuliano após revisão de artroplastia total do joelho. Rev. Port. Ortop. Traum. [online]. 2017, vol.25, n.4, pp.331-338. ISSN 1646-2122.

Disruption of the extensor apparatus, specifically patellar tendon rupture, is a serious complication after total knee arthroplasty. Its reconstruction in patients with chronic ruptures is technically demanding and, given its rarity, lacks a gold standard treatment. This article reports the technique and results of surgical reconstruction of a neglected patellar tendon rupture after revision total knee arthroplasty, using Achilles tendon allograft. At 18 months of follow-up, the patient has an active range of motion between 0° and 110°. The biomechanical principles, responsible for the good results obtained with this technique, are described: rigid fixation of the receptor / donor junction, coverage of the allograft with the maximum of autogenous tissue, in order to maximize its integration, and intraoperative tensioning in extension. We concluded that, in the absence of a gold standard for the treatment of chronic rupture of the patellar tendon after total knee arthroplasty, the choice of surgical technique should depend not only on the timing and location of the rupture, but also on the degree of competence of the host tissues, which will depend on age, comorbidities and previous surgical and non-surgical aggressions to the extensor apparatus.

Keywords : Chronic patellar tendon rupture; Achilles tendon alograft; Revision total knee arthroplasty.

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