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Rare Tendon Rupture after Knee Joint Replacement

"Snip snip" in the world of surgery means that something is about to change. Sometimes the changes make things better--sometimes not. Doctors release a muscle by snipping or cutting it at the tendon. Snipping the quadriceps tendon in the knee may need to be done in some surgeries.

This study reports the results of three patients who had a complete rupture of the quadriceps tendon. The rupture took place in the first eight weeks after surgery to replace the knee joint. All three were heavy, active men who'd had their knee joint replaced. Each one had a snip, or proximal release, of the quadriceps tendon.

The doctors reporting these cases hope to increase awareness of possible problems with this type of tendon release. They conclude that the tendon snip may lead to complete tendon rupture. The treatment method is safe, but the patient must be followed carefully.

Knee flexion may have to be limited to 45 degrees the first week after surgery. Motion can be increased carefully in the weeks after that. Since there was no obvious cause for the ruptures, doctors don't know how to prevent them. Fortunately a quadriceps rupture is rare after total knee replacement, even with a tendon release.

References: Andrew G. Yun, MD, et al. Quadriceps Rupture Associated with a Proximal Quadriceps Release in Total Knee Arthroplasty. In The Journal of Bone and Joint Surgery. September 2003. Vol. 85-A. No. 9. Pp. 1809-1811.

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