caa a22 4500 605457565 CHVBK 20210128100224.0 cr unu---uuuuu 210128e20151201xx s 000 0 eng 10.1007/s00167-014-3189-9 doi (NATIONALLICENCE)springer-10.1007/s00167-014-3189-9 Complications involving the extensor mechanism after total knee arthroplasty [Elektronische Daten] [Rocco Papalia, Sebastiano Vasta, Stefano D'Adamio, Erika Albo, Nicola Maffulli, Vincenzo Denaro] Purpose: To overview the complications involving extensor apparatus of the knee following total knee arthroplasty (TKA) and to summarize which are the lines of treatment available and their reported outcomes in literature. Methods: A comprehensive search of several databases was performed using as basic keywords "complications after TKA”, "extensor mechanism disruption”, "periprosthetic patellar fracture”, "quadriceps tendon rupture”, "quadriceps tendon rupture” isolated or combined with other terms by using Boolean operators. The methodological quality of each article was also evaluated using the Coleman methodology score (CMS). Results: Twenty-nine studies were evaluated. The mean CMS of the studies selected was 33.1/100. Patellar fractures, requiring surgical treatment when there is rupture of the extensor mechanism or loosening of the patellar component, were treated surgically in 28.1% of patients. The patellar and quadriceps tendon ruptures were surgically treated with reconstruction or augmented repair, respectively, in 98.6 and 76.5%. Conclusion: Complications involving the extensor apparatus of the knee following a TKA need early and appropriate management to avoid their devastating influence on joint functionality. Management has to be evaluated very carefully based on the site of the lesion, integrity of the prosthetic components and surrounding tissue to restore, and the patients' individual characteristics. The surgical approach for comminuted periprosthetic fractures and reconstruction of torn tendons of the extensor apparatus are needed to restore function and decrease pain, but, given the poor methodological quality of the studies published so far, it is not clear which surgical technique or graft leads to better outcomes. Therefore, there is an absolute need for better designed comparative trials producing clearer and stronger evidence on this critical matter. Level of evidence: IV. Springer-Verlag Berlin Heidelberg, 2014 TKA nationallicence Post-operative complications nationallicence Extensor mechanism nationallicence Periprosthetic fractures nationallicence Tendon tear nationallicence Papalia Rocco Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, Rome, Italy aut Vasta Sebastiano Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, Rome, Italy aut D'Adamio Stefano Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, Rome, Italy aut Albo Erika Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, Rome, Italy aut Maffulli Nicola Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, 84081, Baronissi, Salerno, Italy aut Denaro Vincenzo Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, Rome, Italy aut Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/12(2015-12-01), 3501-3515 0942-2056 23:12<3501 2015 23 167 https://doi.org/10.1007/s00167-014-3189-9 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 review-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00167-014-3189-9 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Papalia Rocco Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, Rome, Italy aut NATIONALLICENCE 700 1- Vasta Sebastiano Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, Rome, Italy aut NATIONALLICENCE 700 1- D'Adamio Stefano Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, Rome, Italy aut NATIONALLICENCE 700 1- Albo Erika Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, Rome, Italy aut NATIONALLICENCE 700 1- Maffulli Nicola Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, 84081, Baronissi, Salerno, Italy aut NATIONALLICENCE 700 1- Denaro Vincenzo Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 200, Rome, Italy aut NATIONALLICENCE 773 0- Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/12(2015-12-01), 3501-3515 0942-2056 23:12<3501 2015 23 167