LIVRE JDG 2012

Prise en charge des ruptures chroniques de l’appareil extenseur sur PTG

347

The rupture of the quadriceps tendon associated

with a severe patella baja represents a

particular situation. The surgical technique

may be slightly modified. The retraction of the

patellar tendon is such important that the

patella is an «obstacle» to the procedure. We

suggest to perform a total patellectomy while

retaining the fibers of the extensor mechanism

and to use a massive allograft with a complete

patellar tendon, a complete patella and a

quadriceps tendon.

At last, an alternative to the extensormechanism

allograft reconstruction would be the

reinforcement with Synthetic Mesh. This

procedure is being evaluated in our practice.

Fig. 1: Chronic rupture of the patellar tendon

after TKA, preoperative X-rays (case 1).

Fig. 2: Peroperative view (case 1)

Fig. 3: Preparation before reconstruction (case 1)