Problems and solutions of the extensor mechanism

Disruption of the extensor mechanism in a total knee patient is a devastating complication. This article focuses on prevalence, diagnosis, and treatment of a quadriceps tendon tear, patellar fracture, and patellar tendon rupture. Non-surgical management remains the standard of care in patients with a limited extensor lag. Reconstruction with an augment in more severe cases requires rigid fixation, coverage with host tissue, tensioning the augment material, and prolonged postoperative bracing in full extension. Patients continue to exhibit a high rate of complications following this uncommon and dire problem, so understanding the surgical risks and options is crucial.