Protecting a patellar ligament reconstruction after proximal tibial resection: a simplified approach.
Limb salvage in tumor surgery has encouraged the development of megaprostheses. However, reattaching the ligamentum patellae poses a particular problem: avulsion and/or extensor lag may lead to poor function. We describe a new technique of patellar ligament reconstruction. The technique involves reattachment of the patellar ligament to the tibial tuberosity of the proximal tibial megaprosthesis, which has a porous surface created, and the repair is protected with a cerclage wire through the patella and the prosthesis. In 10 consecutive patients, the range of motion averaged 95 degrees (median, 90 degrees ; range, 70 degrees -120 degrees ), and the mean extension lag averaged 4 degrees (median, 0 degrees ; range, 0 degrees -20 degrees ). We had one case of patellar ligament avulsion. This technique resulted in good quadriceps function and a low incidence of complications.


METHODS
Level IV, therapeutic study.
Titus
Vijay
V
South Australian Musculoskeletal Tumour Unit, 2 Moore Street, Toorak Gardens, 5065, SA, Australia.
Clayer
Mark
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001186:Artificial Limbs; D001859:Bone Neoplasms / Q000601:surgery*; D005260:Female; D018212:Giant Cell Tumor of Bone / Q000601:surgery; D006801:Humans; D023821:Limb Salvage; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods*; D012516:Osteosarcoma / Q000601:surgery; D017847:Patellar Ligament / Q000601:surgery*; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures / Q000379:methods; D020127:Recovery of Function; D012189:Retrospective Studies; D013977:Tibia / Q000601:surgery*