Department of Orthopaedic Surgery, University of Cape Town, SA
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arthrosis. 18 , 19 Early TKA pioneers soon revisited their designs when extensor mechanism dysfunction and anterior knee pain became evident. For example, in 1973 the total condylar prosthesis was redesigned to include a proximal flange that could
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Department of Orthopaedic Surgery, International Knee and Joint Centre, Abu Dhabi, UAE
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sleeve. Furthermore, during pre-operative planning, particular attention should be paid to a thorough assessment of extensor mechanism integrity. At the time of the arthroplasty, anterior tibial tuberosity fixation (with screws or tension
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mechanism in the knee, alter the contact forces between the implants, and potentially lead to decreased strength, motion, and an increase in loosening and pain ( 15 , 19 , 20 , 21 , 22 , 23 , 24 ). The degree of these alterations required to produce a
Osteoarticular Surgery Research, Hospital La Paz Institute for Health Research – IdiPAZ (La Paz University Hospital – Autonomous University of Madrid), Madrid, Spain
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knee. Allografts include Achilles tendon, extensor mechanism apparatus, BPTB, or tibialis anterior tendon. The problem with allografts is that they are expensive and sometimes not readily available. Synthetic grafts, such as the Ligament Augmentation
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100% LSI for knee extensor and knee flexor muscle strength was proposed for the pivoting/contact/competitive group. For the non-pivoting/non-contact/recreational group, they recommended at least 90% LSI for the involved limb knee extensor and knee
Department of Orthopaedic Surgery, University of Cape Town, South Africa
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moments and a trend towards increased extensor moments during the mid to late stance phase, which is of uncertain clinical significance. Of note in this study, KAM, the main component of frontal knee kinetics, was lower than typically observed after TKA
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. 4 Schematic diagram illustrating an anterior closing-wedge HTO to reduce the posterior tibial slope in the setting of ACL deficiency. The red arrows represent the function of the extensor mechanism of the knee in the setting of ACL deficiency
Personalized Arthroplasty Society, Atlanta, Georgia, USA
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Personalized Arthroplasty Society, Atlanta, Georgia, USA
Clinique Orthopédique Duval, Laval, Quebec, Canada
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Personalized Arthroplasty Society, Atlanta, Georgia, USA
Clinique Orthopédique Duval, Laval, Quebec, Canada
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Personalized Arthroplasty Society, Atlanta, Georgia, USA
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the extensor mechanism at a side), good flexion is usually obtained, and the knee can be balanced. However, once the patella is reduced (and thus the extensor mechanism), there is often a significant decrease in the ROM due to quadriceps fibrosis
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locations because of capsular adhesions and dysfunction of the extensor mechanism. Tibial avulsions can be reattached using suture anchors or staples. ‘Peel-off’ injuries of the POL can be addressed with suture-anchor fixation. Large implants should be
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more evenly sharing the loading between medial and lateral tibial plateaus. 1 All of these things aim to optimize long-term implant survivorship. Also, it aligns the extensor mechanism, which reduces the risk of patella instability. 2 , 3 Fig
