Literature Search

In order to identify relevant articles to address these questions, in accordance with the PRISMA guidelines, we undertook a systematic search of the PubMed database for articles from January 1966 until March 2020 with the following predetermined inclusion criteria (Figure ​(Figure1):1): (i) published reports on the treatment of deficient extensor apparatus of the knee in patients with PJI after TKA and soft-tissue envelope defects, (ii) all levels of evidence, and (iii) all languages included. Exclusion criteria were reports on (i) extensor apparatus deficiency with an underlying cause other than PJI (e.g. neoplasm, trauma), (ii) treatment of TKA with PJI and a soft-tissue defect that did not specifically address treatment of the deficient extensor apparatus, and (iii) treatment of extensor apparatus deficiency in patients without PJI. Major Medical Subject Heading (MeSH) terms were identified and additional search terms used to narrow the search, using the following six combinations (alternative terms grouped in parentheses): (1) 'Prosthesis-Related Infections' [MeSH] AND ('Extensor' OR 'Extensor Apparatus' OR 'Patellar Tendon'), (2) ('Extensor Mechanism' OR 'Extensor Apparatus') AND 'reconstruction' AND 'infection', (3) 'Treatment' AND ('Periprosthetic Joint Infection' OR 'Implant Associated Infection' OR 'Prosthesis Infection' OR 'Arthroplasty Infection') AND ('Extensor Mechanism' OR 'Extensor Apparatus' OR 'Patellar Tendon'), (4) 'soft tissue defect*' AND 'reconstruction*' AND 'tendon*' AND 'knee*', (5) 'knee' AND ('extensor mechanism' OR 'extensor apparatus') AND 'infection*' AND 'reconstruction*', and (6) 'knee' AND 'tendon* replacement'.

Literature search flow diagram.