Reconstructing Quadriceps Tendon Disruptions in Post Total Knee Arthroplasty Patients with an Autogenous Peroneal Tendon Graft: A Viable Alternative.

Abstract

<h4>Purpose</h4>Quadriceps tendon disruption post-total knee arthroplasty (TKA) is rare. Existing reconstruction procedures use allografts or synthetic meshes with varied success. This study evaluates outcomes with autogenous peroneal tendon grafts, a cost-effective alternative, compared to synthetic polypropylene mesh for quadriceps reconstruction.<h4>Methods</h4>16 patients who underwent extensor mechanism reconstruction between 2017 and 2021were retrospectively analysed. Parameters evaluated included type of reconstruction, extensor lag, IKDC (International Knee Documentation Committee) Score and AOFAS-Hindfoot-score (American Orthopaedic Foot and Ankle Society).<h4>Results</h4>At final follow-up, extensor lag for peroneal autograft group was 6.6° ± 1.5 and for synthetic polypropylene mesh group, 7.2° ± 0.7. Both groups improved in IKDC score (<i>p</i> < 0.01) AOFAS-Hindfoot-score was comparable for peroneal autograft patients with opposite side (<i>p</i> = 0.15).<h4>Conclusions</h4>Autogenous peroneal tendon graft for quadriceps reconstruction could be viable, cost-effective alternative to allografts or synthetic meshes, with good clinical outcomes.<h4>Graphical abstract</h4>Graphical abstract depicting the harvesting of the peronei grafts and their passage through the quadriceps tendon. Sonographic image showing the preoperative presence of a gap in the quadriceps tendon which is reconstructed post-operatively.<h4>Supplementary information</h4>The online version contains supplementary material available at 10.1007/s43465-024-01247-8.