A Modified Surgical Technique of Patellar Tendon Reconstruction in Total Knee Arthroplasty Using Achilles Tendon Allograft

Patellar tendon disruption is one of the most dreaded complications after total knee arthroplasty (TKA) impacting joint function and implant longevity. Management of this condition remains controversial, and no one treatment has provided consistent clinical success. Here we propose a modified technique from the standard Achilles allograft procedure to reconstruct a ruptured patellar tendon after TKA. A freshfrozen Achilles tendon allograft with attached calcaneal bone graft was used. Our technique offers the advantage of a more stable graft fixation by relying on both quadriceps tendon and transosseous patellar fixation and bone-to-bone allograft fixation to the tibial tuberosity. The patient regained full extension and discontinued walking aids postoperatively. Careful attention to graft preparation, tensioning, stable graft fixation, and postoperative rehabilitation led to encouraging results in this complex problem. (c) 2021 The Authors. Published by Elsevier Inc. on behalf of The American Association of Hip and Knee Surgeons. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/ licenses/by-nc-nd/4.0/).