Knee Extensor Mechanism Injuries – Tips and Tricks for Difficult Repairs and Reconstructions-Knee Extensor Mechanism Injuries – Tips and Tricks for Difficult Repairs and Reconstructions (Recording)

Video Transcription

Video Summary

The webinar focuses on knee extensor mechanism injuries, covering primary repairs, revision reconstructions, and complex cases. Dr. Nathan Skelly shares tips for primary extensor tendon repairs, emphasizing proper preoperative planning, understanding tear anatomy via imaging (MRI, ultrasound), preserving tissue, and meticulous surgical techniques like anchor fixation and maintaining leg extension during repair. He highlights the importance of soft tissue management, use of traction sutures, and retinaculum repair to improve outcomes, showcasing cases with successful recovery.<br /><br />Dr. Sam Taylor discusses managing chronic extensor mechanism ruptures with a quadriceps turndown technique, creating a three-sided tendon flap to gain length and enable repair, sometimes augmented with hamstring grafts. He underscores utilizing all viable local tissue and tailoring approaches to individual pathology.<br /><br />Dr. David Bernholt describes allograft reconstructions reserved for failed repairs or chronic cases with poor tissue quality. He details surgical techniques attaching bone block allografts to the patella or tibia, stressing proper tensioning in full extension and highlighting rehabilitation protocols. Despite limited data, successful outcomes with mild extensor lag are achievable.<br /><br />Dr. Joseph Lamplot presents hamstring autograft augmentation for complex or revision extensor repairs, particularly mid-substance patellar tendon ruptures. He explains a technique preserving hamstring insertions, weaving grafts to reinforce repairs and using suture anchors for fixation, illustrated by bilateral injury cases achieving good function postoperatively. Overall, early intervention, thorough planning, and surgical versatility are key to restoring extensor mechanism function.

Keywords

knee extensor mechanism injuries

primary extensor tendon repair

revision extensor reconstruction

quadriceps turndown technique

hamstring graft augmentation

allograft reconstruction

soft tissue management

surgical anchor fixation

extensor mechanism rehabilitation