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A SERIES OF PATELLA TENDON RUPTURES FOLLOWING THE USE OF STATIC CEMENT SPACER BLOCKS IN STAGED REVISION KNEE ARTHROPLASTY FOR INFECTION



Abstract

Purpose of the study: We report an unusual complication of patella tendon rupture that occurred secondary to the use of static cement spacer blocks in a series of three patients undergoing staged revision total knee arthroplasty (TKA) for infection.

Methods and results: 3 male patients developed patella tendon injury secondary to anterior subluxation of static cement spacer blocks used at the first of a two-stage revision procedure for infected TKA. Average patient age was 70 years. The interval between the 1st and the 2nd stages varied between 3.5 to 24 months. At the second stage, it was observed that the patella tendon was completely severed and irreparable in one case, whereas it was partially injured and repairable in the other two cases. In the case with irreparable tendon injury, stable joint reconstruction could not be achieved at the second stage and ultimately resulted in knee arthrodesis. In the other two cases, 2nd stage revision was performed using hinged revision knee components and the tendon injury was repaired and protected with a circlage wire. None of the patients were satisfied with their outcome at the final review.

Conclusion: This is the first report in the literature reporting the complication of patella tendon rupture secondary to the use of static cement spacer blocks in staged revision knee arthroplasty. The injury can either be repairable or irreparable. The functional outcome and satisfaction is not good after the salvage procedures. Therefore, we recommend that these spacer blocks should not be used in revision knee arthroplasty.

Correspondence should be addressed to: BASK c/o BOA, at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London, WC2A 3PE, England.