title: Reconstruction of the patella with an autogenous iliac graft: clinical and radiologic results in thirteen patients.
abstract: OBJECTIVE
  Extension lag, quadriceps weakness and subluxation of the extensor apparatus are known complications of patellectomy. In the case of total knee joint replacement with a nonconstrained system an instability may be encountered. Reconstruction of the patella allows restoration of the moment arm to improve quadriceps leverage. The goal of our study was to analyse the clinical and radiological results after reconstruction of the patella with an autogenous iliac graft.
  
  
  METHODS
  13 previously patellectomized patients had reconstruction of the patella with an autogenous iliac graft and were retrospectively studied by clinical and radiographic examination. For evaluation we used the scores of Feller and the Knee Society. Also, all complications were recorded.
  
  
  RESULTS
  After an average follow-up of 40.1 months, nine patients had full strength of the quadriceps, while six had an improved function of the extensor apparatus. The mean Feller score was 21.8 and the Knee Society score was 67.3 for knee and 57.5 for function. Six complications occurred including three infections, two problems with the replaced patella and one fracture of the anterior superior iliac spine.
  
  
  CONCLUSIONS
  Reconstruction of the patella with an autogenous iliac graft enables the strength of the extensor apparatus with restoration of the knee joint.
authors.affiliation: Orthopaedic Department, Hannover Medical School, Diakoniekrankenhaus Annastift, Hannover, Germany. d.daentzer@t-online.de
authors.forename: Dorothea
authors.initials: D
authors.lastname: Daentzer
authors.forename: Maximilian
authors.initials: M
authors.lastname: Rudert
authors.forename: Carl Joachim
authors.initials: CJ
authors.lastname: Wirth
authors.forename: Christina
authors.initials: C
authors.lastname: Stukenborg-Colsman
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016025:Bone Transplantation; D005260:Female; D006801:Humans; D007085:Ilium / Q000637:transplantation*; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D017063:Outcome Assessment, Health Care; D010329:Patella / Q000503:physiopathology / Q000601:surgery*; D011183:Postoperative Complications; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D020127:Recovery of Function; D012086:Reoperation; D012189:Retrospective Studies; D014182:Transplantation, Autologous