Extensor mechanism reconstruction: a novel technique for bone patella allograft post partial patellectomy failure

Area of Science:

• Orthopedic surgery
• Musculoskeletal reconstruction
• Trauma surgery

Background:

• Extensor mechanism disruption, often from patellar fracture or tendon rupture, typically results from low-energy trauma.
• Partial patellectomy is standard for irreparable patellar fractures, but tendon repair failure leaves limited tissue for reconstruction.
• Existing allograft techniques are reported for extensor mechanism repair post-total knee arthroplasty, not typically for post-traumatic defects after patellectomy.

Observation:

• A 28-year-old active patient experienced extensor mechanism failure after a patellar fracture and subsequent partial patellectomy.
• A novel technique utilizing a bone patellar tendon bone allograft was employed to reconstruct the post-traumatic extensor mechanism defect.
• The patient had inadequate native tissue for conventional extensor mechanism restoration.

Findings:

• Radiographs confirmed allograft union at 4 months post-surgery.
• The patient achieved full range of motion within 6 months.
• The patient successfully returned to his previous level of sporting activity.

Implications:

• This bone patellar tendon bone allograft technique offers a viable solution for complex extensor mechanism reconstruction in young, active patients with failed prior surgeries.
• It provides a method to restore function and enable return to high-demand activities following traumatic patellar injuries and subsequent complications.
• Further research may explore the long-term efficacy and broader application of this allograft strategy in traumatic extensor mechanism defects.