gms | German Medical Science

54. Jahrestagung der Norddeutschen Orthopädenvereinigung e. V.

Norddeutsche Orthopädenvereinigung

16.06. bis 18.06.2005, Hamburg

Whole extensor mechanism allografts in knee revision surgery. A real alternative

Meeting Abstract

  • corresponding author M. Ribas - Institut Universitari Dexeus, Universitat Internacional de Catalunya, Fundació ICATME, Traumatologie, Orthopädische Chirurgie und Sportsmedizin, Barcelona
  • J. Vilarrubias - Barcelona
  • J. Leal - Barcelona
  • J. Silberberg - Barcelona
  • I. Ginebreda - Barcelona

Norddeutsche Orthopädenvereinigung. 54. Jahrestagung der Norddeutschen Orthopädenvereinigung e.V.. Hamburg, 16.-18.06.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc05novK5.04

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Veröffentlicht: 13. Juni 2005

© 2005 Ribas et al.
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Knee revision in absence of Extensor Mechanism has been always a challenging problem in Orthopaedics. Many authors are in favour to abandone any endoprosthetic substitution in front

of such a situation.

We think osteotendinous allografts, in this particular case whole Extensor Mechanism allografts, could play an essential role before any Knee Arthrodesis.

Material and Method

From 1999 up to 2003, 11 patients (4 male, 7 female) (mean age 72, range 68 to 86) underwent to a whole Extensor Mechanism allografting procedure. Mean follow up was 2,7 years (1 to 5 years). 7 patients had an infected TKA with lack of distal extensor mechanism. These were treated in two stages. In the first four cases a single whole Extensor Mechanism allograft was implanted (group A), while in the next seven cases the allograft was reinforced by means of a Leeds-Keio Dacron band (group B).


There was neither infection nor reactivation in the whole serie. The mean obtained R.O.M. in the first three months was - 7,5º active extension (range -5º to -15º) and 83º active flexion (range 65º - 110º) without any statistical difference between both groups (p=0,272). After 18 months in group A there was a mean -26º active extension (-20º to - 35º) and 89º active flexion (range 80º to 105º), whereas in group B there was only a mean lack of active extension of -9º (range -5º to -20º) with 82º of flexion (70º to 105º). These differences were statistical significant (p=0,0473). Ultrasound exams showed in cases of group A a major thining pattern without any sign of rupture.


Extensor Mechanism allografts are very useful in difficult knee revisions with absence of Extensor Mechanism, so that Knee Arthrodesis is not the method of choice for these patients, even in septic TKA loosenings. However augmentation of patellar tendon is necessary to maintain over the years an active extension.