Despite high complication rates, patients with open knee extensor mechanism injuries who required staged allograft reconstruction generally had favorable results, according to study results.
Researchers retrospectively reviewed 14 consecutive patients who sustained 17 complex, open knee extensor mechanism injuries during combat operations between March 2003 and May 2012. Patients underwent primary repair or staged allograft extensor reconstruction after serial debridement and closure or soft tissue coverage.
Main outcome measures included final knee range of motion, extensor lag, ambulatory ability and assist devices, as well as complications requiring reoperation or salvage procedure.
Overall, a mean of 11 procedures were required per open knee extensor mechanism injury. Study results showed all patients achieved regular community ambulation at a mean final follow-up of 39 months, with 36% requiring assist devices due to concomitant or bilateral injuries.
The researchers found an average knee flexion of 92°. Although 35% of extremities had an extensor lag of greater than 10°, six of nine extremities with allograft reconstructions had extensor lags of less than 10° and five had no extensor lag.
Presence of a major periarticular or patellar fracture was significantly associated with the knee requiring a subsequent extensor mechanism allograft reconstruction procedure, according to the researchers.
Due to severe infection, one extremity each underwent knee arthrodesis or transfemoral amputation.
Disclosure: The authors have no relevant financial disclosures.