title: De Novo Reconstruction of a Hybrid Patella by Staged Fabrication of a Microvascular Bone Transplant with an Osteointegrated Prosthetic Socket.
abstract: Total patellectomy is sometimes unavoidable but usually results in severely impaired function, pain, and instability in the affected knee. Any patellar prosthetic solutions rely on a certain amount of remaining bone and therefore are not applicable after total patellectomy. Traditionally, reconstruction of a neopatella by avascular or allogeneic bone grafts is hampered by mechanical failure, resorption, or infection. We developed a new, 3-stage approach to reconstruct a hybrid patella composed of a revascularized scapula tip transplant fabricated with a prosthetic socket. The procedure is safe and provides optimal healing and prosthetic osteointegration through viable bone and dynamic stability to the considerable load a patella has to bear in unrestricted mobility. The technique also demonstrates successful integration of orthopedic prosthetic devices into current flap fabrication concepts.
authors.affiliation: Clinic for Plastic Reconstructive, Aesthetic and Hand Surgery, Gesundheit Nordhessen, Kassel, Germany; and Orthopedic Clinic Werneck, Werneck, Germany.
authors.forename: Goetz A
authors.initials: GA
authors.lastname: Giessler
authors.affiliation: Clinic for Plastic Reconstructive, Aesthetic and Hand Surgery, Gesundheit Nordhessen, Kassel, Germany; and Orthopedic Clinic Werneck, Werneck, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Hendrich