Early Quadriceps Tendon Rupture After Total Knee Arthroplasty

Presenting Author - JIGAR CHHAPAN
Introduction & aims – Extensor mechanism disruption following Total knee arthroplasty (TKA) is rare complication and results in significant morbidity and severe functional limitation. Quadriceps tendon rupture is one of them. Relatively little information is available about quadriceps tendon tears after TKA. Method – This is a retrospective study of 10 quadriceps tendon rupture in 7 patients out of 2404 patients of primary TKA operated between June 2015 and May 2016 at our institute. The rupture was due to sudden fall while walking or getting up from chair. All 7 patients presented with hematoma formation around the knee, inability to get up and inability to walk. It was diagnosed clinically by palpable gap over the quadriceps mechanism, absent straight leg raise and inability to extend the knee. Diagnosis was confirmed by ultrasonography and managed by exploration and end to end tendon repair by ethibond suturing. Patients were immobilised in knee extension for 6 weeks and mobilisation started thereafter. Results – Incidence of quadriceps tendon tear after total knee arthroplasty in our study was 0.29% (7 of 2404). All patients developed rupture within 20-60 days of primary TKA and achieved pre operative range of motion without extension lag and flexion or extension restriction within 6 months of repair. Conclusions – Early identification and prompt treatment of quadriceps tendon injury followed by controlled post operative rehabilitation will give excellent short term and midterm outcome.