Knee extensor mechanism reconstruction with medial gastrocnemius flap

Infection after osteotomy of the tibial tubercle can lead to nonunion and chronic osteomyelitis of the tuberosity. Radical debridement for control of infection in this situation may require resection of the sequestrated tuberosity fragment with the resultant problem of disruption of the extensor mechanism of the knee. A review of the literature failed to identify any description of successful treatment of such a complication. The case of a 28-year-old woman with this complication is reported. After resection of the sequestrated tibial tuberosity and sinus tract, the extensor mechanism was reconstructed with the medial gastrocnemius flap in a one-stage procedure. The infection was eradicated successfully and excellent knee function was restored. The technique and 5-year result are presented.