Marlex Mesh Reconstruction of the Extensor Mechanism

Abstract

Marlex mesh reconstruction of the extensor mechanism following total knee arthroplasty (TKA) has demonstrated excellent early results. The purpose of the present study was to evaluate longer-term results of Marlex mesh reconstruction of the extensor mechanism in 93 TKAs. Seventy-seven reconstructions were aseptic, and 16 were performed as part of a 2-stage exchange for the treatment of infection. Mean follow-up was 8 years. Twenty-eighty patients experienced mesh failure. Seventeen failures were treated with mesh revision (8 for patellar tendon rupture, 7 for quadriceps tendon rupture, and 2 for symptomatic lengthening). The 10-year cumulative incidence of mesh revision for mesh failure was 20%. Extensor lag improved by a mean of 28°, with a mean extensor lag of 9° at most recent follow-up. At a mean follow-up of 8 years, Marlex mesh reconstruction was a durable and reliable technique to treat both aseptic and septic ruptures of the extensor mechanism. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.