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Related Experiment Videos

Reconstructed patellar tendon length after proximal tibia prosthetic replacement.

Shoji Shimose1, Takashi Sugita, Tadahiko Kubo

  • 1Department of Orthopaedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, Japan. shimose@hiroshima-u.ac.jp

Clinical Orthopaedics and Related Research
|October 6, 2005
PubMed
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Proximal tibia reconstruction can cause extensor lag. Maintaining patellar tendon length and using a gastrocnemius flap helps minimize this, despite tendon stretching, improving knee function post-surgery.

Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Oncology

Background:

  • Prosthetic reconstruction of the proximal tibia for malignant bone tumors presents challenges.
  • A common complication is extensor lag due to insufficient extensor mechanism function.
  • Preserving patellar tendon length is crucial for minimizing extensor lag.

Purpose of the Study:

  • To evaluate the serial changes in patellar tendon length and extensor lag after proximal tibia prosthetic reconstruction.
  • To assess the effectiveness of patellar tendon reattachment with a synthetic material and gastrocnemius flap in managing extensor lag.

Main Methods:

  • Seven patients with malignant bone tumors underwent proximal tibia prosthetic reconstruction.
  • Patellar tendon length was measured using the Insall-Salvati ratio at 30 and 60 degrees of knee flexion.

Related Experiment Videos

  • The extensor mechanism was reconstructed with synthetic material and a gastrocnemius flap.

    • Main Results:

    • The Insall-Salvati ratio decreased postoperatively but returned to preoperative values within 18 months.
    • A higher ratio was observed at 60 degrees compared to 30 degrees flexion at 6 months.
    • Extensor lag improved continuously for 12 months, and remained stable even after prosthesis revision without reattachment.

    Conclusions:

    • Strong continuity of the patellar tendon, gastrocnemius flap, and leg extensors effectively decreases extensor lag.
    • Patellar tendon stretching occurs but does not preclude functional improvement.
    • This reconstructive technique aids in restoring knee extensor function after proximal tibia tumor resection.