SURGICAL TECHNIQUE: Mesh Graft for Extensor Mechanism Disruption

    Extensor mechanism disruption is a dramatic complication of total knee arthroplasty, often resulting in poor results of the procedure. It is typically treated with Achilles tendon allograft or whole extensor mechanism allograft, both of which have their pros and cons.

    There is another option: synthetic mesh reconstruction. Popularized by Arlen D. Hanssen, MD, the synthetic mesh graft has become the preferred treatment option for extensor mechanism disruption at Mayo Clinic.

    At ICJR’s 6th Annual Revision Hip & Knee Course, Matthew P. Abdel, MD, demonstrated the surgical technique he and his Mayo Clinic colleagues use for synthetic mesh reconstruction, noting this is a cost-effective option that avoids the limitations of allograft use and, with experience, is an efficient surgical technique that can be executed in a systematic manner.

    During his presentation, Dr. Abdel reviewed:

    • Graft preparation
    • Tibial trough preparation
    • Insertion of the mesh and lag screw
    • Distal and proximal incorporation of the graft
    • Creation of a unitized lateral/mesh base
    • Closure by the pants-over-vest technique to cover the entire mesh

    Dr. Abdel also reviewed the latest data on survivorship of the mesh graft in procedures done at Mayo Clinic.

    Click the image above to watch Dr. Abdel’s presentation and learn more about the surgical technique for use of a synthetic mesh graft in extensor mechanism disruption.