Posted: Mar 22 2020 #(C101403)

TKA Patellar Tendon Rupture in 72F

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HPI

2 weeks s/p left total knee arthroplasty, visiting in town and had a trip and fall, with an acute onset of knee swelling and inability to extend leg

PMH

HTN, CKD 2, Ehlers Danlos Syndrome

BMI 33. Anterior midline knee incision closed with staples in place. No erythema or drainage. Significant effusion with hypermobile patella. Unable to straight leg raise. Neurovascularly intact distally.

Poll

1 of 4

What additional imaging studies would you obtain?

1 CT scan

2 MRI scan

3 Ultrasound

4 No additional studies needed

Other

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P: 110028

What would you recommend next?

1 Drop-lock hinge brace/knee immobilizer

2 Direct repair of patellar tendon

3 Revision patellar arthroplasty

4 Extensor mechanism reconstruction

Other

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P: 110029

If opting for extensor mechanism reconstruction, what construct would you utilize?

1 Achilles tendon allograft

2 Whole extensor mechanism allograft

3 Aortobifemoral endograft

4 Marlex mesh

5 Local tendon augmentation (e.g. hamstrings)

Other

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P: 110030

How soon would you return to surgery?

1 As soon as possible

2 Once the skin wound has healed

3 At least 6 weeks after the initial TKA in order to decrease DVT risk

4 At least 3 months after the initial TKA in order to decrease infection risk

Other

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P: 110031

Intra-procedure P1

Post-procedure P2

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