Patellar Tendon Reconstruction for a Chronic Extensor Mechanism Deficit Using an Achilles Tendon Allograft With Hamstring Autograft and Suture Augmentation

Patellar tendon ruptures are the third most common injury to the extensor mechanism. These injuries are debilitating to the patient, and delays in treatment can present a challenge to the treating surgeon. Chronic patellar tendon injuries are rare and are more difficult to manage given proximal patellar retraction, scarring, and atrophy of surrounding tissues. There is no consensus on the optimal approach for treatment, and numerous reconstruction techniques have been described using a variety of graft choices and fixation methods. We describe our surgical technique for a 3-fold reconstruction of a chronic patellar tendon rupture using an Achilles tendon allograft augmented with a vascularized ipsilateral hamstring tendon autograft and additional FiberTape augmentation. The aim of this procedure is to restore patellar height and prevent extensor lag.