股四头肌肌腱断裂:叙述回顾。

IF 0.5 4区 医学 Q4 ORTHOPEDICS
Annals of Joint Pub Date : 2025-04-22 eCollection Date: 2025-01-01 DOI:10.21037/aoj-24-66
Joshua A Whitmore, Prachi Lele, Joseph G Lyons, Andrew Froehle
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引用次数: 0

摘要

背景和目的:股四头肌肌腱断裂既可以发生在原膝关节,也可以发生在之前接受过全膝关节置换术(TKA)的膝关节。完全破裂需要手术治疗以优化患者功能。关于原生破裂的理想修复技术存在争议,对于tka后破裂的最佳手术治疗选择几乎没有共识。这篇叙述性综述的目的是概述发生在原生膝关节和TKA环境中的股四头肌肌腱断裂,重点是当代治疗方案及其结果。方法:于2024年11月对相关文献进行叙述性复习。我们回顾了截至2024年11月发表的与股四头肌肌腱断裂有关的英文文章,包括原生膝关节和tka后膝关节。所有类型的已发表文章都被考虑在内。主要内容和发现:股四头肌肌腱断裂几乎总是发生在先前有肌腱病理的患者中。大量文献支持急性原生股四头肌破裂的初步修复,并且大多数患者的预后合理。在这种情况下,经骨和缝合锚钉修复技术的临床结果似乎是相似的。四头肌破裂,发生在TKA的情况下,更难治疗。在这种情况下,初级修复、增强修复和重建的并发症发生率很高。即使有了当代重建选择的改进,包括同种异体移植物和合成补片,结果仍然不理想。需要更多的工作来改善tka后四头肌肌腱断裂患者的预后。结论:采用现代技术治疗原发性股四头肌肌腱断裂可获得一般可靠的结果。另一方面,在TKA的情况下发生的股四头肌破裂,治疗起来更具挑战性。各种外科技术已经被探索和发展,以努力改善结果。虽然已经实现了适度的改进,但这些损伤仍然存在问题,无论采用何种技术,其并发症和失败率都很高。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Quadriceps tendon ruptures: a narrative review.

Background and objective: Quadriceps tendon ruptures can occur in both the native knee and in knees which have undergone prior total knee arthroplasty (TKA). Complete ruptures require surgical treatment to optimize patient function. Debate exists surrounding the ideal repair technique for native ruptures, and there is little consensus regarding the optimal surgical treatment option for post-TKA ruptures. The objective of this narrative review is to provide an overview of quadriceps tendon ruptures occurring in both native knees and in the setting of TKA, with a focus on contemporary treatment options and their results.

Methods: A narrative review of the relevant literature was performed in November 2024. English language articles published up to November 2024 which related to quadriceps tendon ruptures, involving both the native knee and the post-TKA knee, were reviewed. All types of published articles were considered.

Key content and findings: Quadriceps tendon ruptures almost always occur in patients with antecedent tendon pathology. Primary repair of acute native quadriceps ruptures is supported by a large body of literature, and most patients have reasonable outcomes. The clinical outcomes of transosseous and suture anchor repair techniques seem to be comparable in this setting. Quadriceps ruptures, which occur in the setting of TKA, are much more difficult to treat. In this setting, the complication rates of primary repair, repair with augmentation, and reconstruction are high. Even with improvements in the contemporary reconstructive options, including allograft and synthetic mesh, outcomes remain suboptimal. More work is needed to improve outcomes for patients with post-TKA quadriceps tendon ruptures.

Conclusions: Generally reliable results can be achieved when treating native quadriceps tendon ruptures with contemporary techniques. Quadriceps ruptures, which occur in the setting of TKA, on the other hand, are much more challenging to treat. Various surgical techniques have been explored and developed in an effort to improve outcomes. While modest improvements have been realized, these injuries remain problematic, with very high complication and failure rates, regardless of technique.

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来源期刊
Annals of Joint
Annals of Joint ORTHOPEDICS-
CiteScore
1.10
自引率
-25.00%
发文量
17
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