Autogenous patella as replacement for a resected femoral or tibial condyle. A report on 19 cases.
The size and shape of the patella make it suitable for the partial replacement of a femoral or tibial condyle resected for tumour, or destroyed by trauma. It can provide a good articular surface and may give satisfactory knee function. Nineteen cases of patellar grafts are presented, with follow-up from two to nine years. Good consolidation of the graft and fair stability of the joint were obtained; the range of movement was 90 degrees or more in 79% of cases. In contrast with an allograft of a femoral or tibial condyle, the technique described does not need an allograft bank, has a lower risk of infection, and allows better and quicker consolidation and revascularisation of the grafts, as well as a better range of movement at the knee, probably because of the lack of fibrosis from immunological reaction. Merle d'Aubigné's technique, using a patellar graft with a vascular muscle pedicle, is useful only for some cases, requires a longer period of immobilisation and weakens the extensor apparatus. Our series shows that consolidation and revascularisation of a patellar graft can occur in the absence of a pedicle.
D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000601:surgery*; D005260:Female; D005266:Femoral Neoplasms / Q000601:surgery*; D005269:Femur / Q000293:injuries / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008722:Methods; D008875:Middle Aged; D010329:Patella / Q000098:blood supply / Q000637:transplantation*; D013977:Tibia / Q000293:injuries / Q000601:surgery*