title: Patellar tendon reconstruction using an extended gastrocnemius flap following cryogenic injury to the knee.
abstract: Cryogenic thermal necrosis after knee surgery is rare. We describe a patient who presented with an anterior knee soft tissue defect in conjunction with an extensor mechanism deficiency secondary to a cold thermal injury after an anterior cruciate ligament reconstruction. We treated the patient with a single stage surgical procedure combining patellar tendon reconstruction and soft tissue coverage utilizing the superficial portion of the patient's vascularized Achilles tendon attached to a medial gastrocnemius flap. The patient returned to unrestricted activities and has demonstrated this through a five year follow-up.
authors.affiliation: Colorado Joint Replacement, Denver, CO, United States; Dept. of Biomedical Engineering, University of Denver, United States; Department of Orthopedic Surgery, Joan C. Edwards School of Medicine at Marshall University, United States. Electronic address: raymondkim@centura.org.
authors.forename: Raymond H
authors.initials: RH
authors.lastname: Kim
authors.affiliation: Northwestern University Feinberg School of Medicine, United States.
authors.forename: Amanda H
authors.initials: AH
authors.lastname: Randolph
authors.affiliation: Private Practice Plastic Reconstructive and Hand Surgery, Denver, CO, United States.
authors.forename: Conrad J
authors.initials: CJ
authors.lastname: Tirre
authors.affiliation: Ortho San Antonio, San Antonio, TX, United States; Department of Orthopedics, UT Health Science Center at San Antonio, United States.
authors.forename: Matthew
authors.initials: M
authors.lastname: Morrey
authors.affiliation: Colorado Joint Replacement, Denver, CO, United States.
authors.forename: Jason M
authors.initials: JM
authors.lastname: Jennings
mesh_terms: D000125:Achilles Tendon / Q000637:transplantation; D000328:Adult; D017679:Cryotherapy / Q000009:adverse effects*; D003646:Debridement; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000209:etiology / Q000601:surgery*; D009336:Necrosis; D017847:Patellar Ligament / Q000473:pathology / Q000601:surgery*; D017695:Soft Tissue Injuries / Q000209:etiology / Q000601:surgery*; D013524:Surgical Flaps
keywords: Cryogenic injury; Extensor mechanism; Necrosis