Complications - OtherExtensor Mechanism Reconstruction Using Marlex Mesh: Is Postoperative Casting Mandatory?
Section snippets
Study Sample
This study used our prospectively collected and institutional review board–approved total joint replacement registry to retrospectively review consecutive patients with EM compromise at a single tertiary referral center. Patients were included in the study if they underwent EM reconstruction with Marlex mesh. Patients were excluded if they underwent EM reconstruction using allograft or underwent EM repair. Additional preoperative diagnoses, including cases of septic revisions for periprosthetic
Results
During the study period, a total of 45 patients were treated for EM disruption. Three patients were treated with EM reconstruction using allograft, and 12 patients underwent EM repair for an acute rupture and were excluded from analysis. A total of 33 knees (30 patients) underwent Marlex mesh reconstruction of an EM disruption and were included in the final analysis. In 10 knees, the existing implants were retained, and in 23 knees, the implants were revised. Among the 23 EM reconstructions in
Discussion
Disruption of the EM of the knee is a devastating complication with significant associated patient morbidity, including decreased walking ability, instability and, by definition, the inability to extend the knee. Multiple strategies exist to address an EM disruption after TKA. Nonsurgical management and primary repair strategies have uniformly resulted in poor functional outcomes and high rates of revision for chronic EM disruptions [1,4,9,13]. Traditionally, allograft augmentation has been
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One or more of the authors of this paper have disclosed potential or pertinent conflicts of interest, which may include receipt of payment, either direct or indirect, institutional support, or association with an entity in the biomedical field which may be perceived to have potential conflict of interest with this work. For full disclosure statements refer to https://doi.org/10.1016/j.arth.2020.06.037.
Funding: This research received no specific funding/grant from any funding agency in the public, commercial, or not-for-profit sectors.
Conflict of Interest: Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.
Ethical Board Review: This study received institutional review board approval before initiation. The study was performed in accordance with the ethical standards in the 1964 Declaration of Helsinki. This study was carried out in accordance with relevant regulations of the US Health Insurance Portability and Accountability Act.