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Is there a role for synthetic ligaments in the reconstruction of patellar tendon chronic rupture after TKA? Our experience with LARS ligament and surgical technique
ESSKA Academy. Giuntoli M. Nov 8, 2019; 284378; epEKA-41 Topic: Joint Replacement
Dr. Michele Giuntoli
Dr. Michele Giuntoli
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Is there a role for synthetic ligaments in the reconstruction of patellar tendon chronic rupture after TKA? Our experience with LARS ligament and surgical technique

ePoster - epEKA-41

Topic: TKA

Giuntoli M., Bonicoli E., Piolanti N., Vigorito A., Marchetti S., Scaglione M.
Università Degli Studi di Pisa, Pisa, Italy

Introduction: Patellar tendon rupture (PT-R) is a rare complication in Total Knee Arthroplasty (TKA) and often requires surgical treatment. When chronic lesions or tendon degeneration occurs, good results have been reported using autografts or allografts. Allografts have high costs, limited availability, increased risk of immune reactions and infection and poor outcomes at long-term follow-up (FU). Recently, the use of synthetic ligaments for patellar tendon reconstruction has taking place with encouraging results.
Aims: To assess clinical, ecographic and radiographic outocmes in the treatment of PT-R after TKA using the Ligament Advanced Reinforcement System-LARS® at mid-term FU.
Methods: Clinical evaluation was performed using Knee Society Score and recording extensor lag. Ultrasound imaging was made to evaluate patellar tendon thickness and conventional x-rays to assess prosthesis mobilization signs and patella's height.
Results: At last FU, 6 knees were included. Patient mean age was 66.7. Patellar tendon reconstruction occurred after a mean time of 4 months from the previous surgery. The mean FU was 44,2 months with a mean Knee Score of 63.3 and a mean Function Score of 35. In 4 knees extensor lag was < 10° while in 2 knees it was > 20°. The mean Insall-Salvati Index (ISI) was 1.16, while the average increase in tendon thickness was 127.12%.
Conclusions: Synthetic ligaments can be successful employed in the reconstruction of patellar tendon breakage after TKA and rTKA in selected patients, in order to quickly return to activity of daily living.
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