Total Knee Arthroplasty in a Patellectomised Posterior Cruciate Ligament-deficient Knee: a New Technique of Patellar Tendon Bone Grafting

Total knee arthroplasty in patients with previous patellectomy are less successful because of anteroposterior instability, residual pain and the loss of the mechanical advantage of the patella. To restore the moment arm of the quadriceps, the senior author (C.W.) described the technique of bone grafting the patellar tendon in a patient using the tibial plateau obtained from the routine tibial cut during total knee arthroplasty. The tibial eminence was used as the interfacetal ridge of the 'created' patella. At follow-up, the results were excellent with a postoperative knee society score of 90 and a postoperative patient functional score of 92. Radiological investigations showed a well-incorporated graft in the patellar tendon.