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Synthetic Mesh Effective for Patellar Tendon Reconstruction

Significant improvement in pain and function scores, with no loss of extension at follow-up

WEDNEDSAY, June 29 (HealthDay News) -- Reconstruction of patellar tendon disruption using synthetic mesh is an effective technique, according to a study published in the June 15 issue of The Journal of Bone & Joint Surgery.

James A. Browne, M.D., from the University of Virginia in Charlottesville, and Arlen D. Hanssen, M.D., from the Mayo Clinic in Rochester, Minn., investigated the outcome of a new surgical method that uses synthetic mesh for patellar tendon reconstruction. The study included 13 patients, with an average age of 60 years, who underwent extensor mechanism reconstruction for subacute or chronic patellar tendon disruption. Five of the patients had already undergone unsuccessful treatment with an allograft extensor mechanism reconstruction, and eight patients had undergone prior revision arthroplasty. A knitted monofilament polypropylene graft was used to reconstruct the patellar tendon and to assist fixation of adjacent host tissue into the graft. All patients were followed up at an average of 42 months.

The investigators found that graft reconstruction failed in three patients within six months. One patient with previous sepsis was treated with a knee arthrodesis after a recurrent infection. An extensor lag of no greater than 10 degrees was seen in the remaining nine patients, who reported no loss of extension during final follow-up. No clinically significant loss of knee flexion was seen. There was a significant improvement in the mean Knee Society scores for pain and function. Compared with allograft, synthetic mesh was a significantly less expensive reconstruction option.

"The use of synthetic mesh to reconstruct a disrupted patellar tendon is a straightforward surgical procedure that was successful and durable in the majority of patients in our series," the authors write.

One or more of the authors disclosed financial ties with Stryker and Ortho Development.

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