{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:36:18Z","timestamp":1787754978561,"version":"build-2784847793"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Journal of Bone and Joint Surgery"],"published-print":{"date-parts":[[2019,6,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Quadriceps tendon rupture following total knee arthroplasty (TKA) is an infrequent but potentially devastating adverse event. Although uncommon, the long-term sequelae of this injury can result in permanent inability to walk. Despite the severity of this injury, there is no single accepted treatment, with various surgical methods producing mixed results. Therefore, the purpose of this study was to assess the efficacy of a modified V-Y turndown flap as a viable alternative method of treatment for this injury.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Twenty-four quadriceps tendon ruptures in 23 patients (10 men and 13 women) who underwent TKA (8 primary and 15 revision), including 1 tendon rerupture, were treated with use of a modified V-Y turndown. The average patient age at the time of the V-Y flap repair was 61 years (range, 41 to 86 years). Knee Society scores, range of motion, strength, medical comorbidities, nature of the procedure (i.e., primary versus revision), and the ability to walk were all recorded before and after the quadriceps reconstruction, along with general satisfaction and adverse events following the procedure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Twelve patients (52%) had predisposing comorbidities, including obesity, diabetes, chronic dialysis, and steroid dependence. Prior to repair with the V-Y flap, none of the patients were able to walk independently, requiring either a wheelchair or walker. No patient had quadriceps strength greater than 3 (of 5), although all had full passive extension. Following the repair procedure, patients had significant (p &lt; 0.0001) improvements in mean Knee Society knee score (88.7; range, 45 to 95) and mean strength (4.8; range, 3 to 5), and all were able to walk without assistive devices. Twenty knees exhibited active range of motion of 0\u00b0 to 120\u00b0, whereas 4 had residual extensor lag of \u22655\u00b0 (range, 5\u00b0 to 35\u00b0). Major adverse events were limited to a single hematoma and an unacceptable extensor lag (35\u00b0) after repair.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The modified V-Y quadriceps tendon turndown flap was a reliable alternative treatment for achieving restoration of the extensor mechanism after complete quadriceps tendon rupture following TKA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Therapeutic\n                      <jats:underline>Level IV<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.18.01098","type":"journal-article","created":{"date-parts":[[2019,6,6]],"date-time":"2019-06-06T09:38:25Z","timestamp":1559813905000},"page":"1010-1015","source":"Crossref","is-referenced-by-count":18,"title":["Modified V-Y Turndown Flap Augmentation for Quadriceps Tendon Rupture Following Total Knee Arthroplasty"],"prefix":"10.2106","volume":"101","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1588-3403","authenticated-orcid":false,"given":"Shao-Min","family":"Shi","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8764-8886","authenticated-orcid":false,"given":"Glenn G.","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Mayo Clinic, Jacksonville, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2328-2886","authenticated-orcid":false,"given":"Emily M.","family":"Laurent","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3500-7777","authenticated-orcid":false,"given":"James T.","family":"Ninomiya","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"issue":"2","key":"bib1-20230810","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/0883-5403(94)90061-2","article-title":"Clinical comparison of the Miller Galante I and AMK total knee systems","volume":"9","author":"Kirk","year":"1994","journal-title":"J Arthroplasty."},{"issue":"4","key":"bib2-20230810","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1016\/S0883-5403(99)90100-6","article-title":"Eliminating patellofemoral complications in total knee arthroplasty: clinical and radiographic results of 121 consecutive cases using the Duracon system","volume":"14","author":"Mont","year":"1999","journal-title":"J Arthroplasty."},{"key":"bib3-20230810","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1097\/00003086-199610000-00004","article-title":"The Ranawat Award. 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