caa a22 4500 605458766 CHVBK 20210128100230.0 cr unu---uuuuu 210128e20150401xx s 000 0 eng 10.1007/s00167-014-2845-4 doi (NATIONALLICENCE)springer-10.1007/s00167-014-2845-4 Achilles tendon allograft for augmentation of the Hanssen patellar bone grafting [Elektronische Daten] [Friedrich Boettner, Jad Monsef] Purpose: Severe patellar bone loss precludes the insertion of another patellar implant in revision total knee arthroplasty (TKA) and weakens the attachment of the patella to the quadriceps tendon. Hanssen described securing a tissue flap to the patellar rim allows the delivery of cancellous bone graft into the patellar bone defect. The purpose of this study is to describe the surgical technique and early clinical results of a modified Hanssen patelloplasty with an Achilles tendon allograft. Methods: The modified technique described in three patients undergoing revision TKA aims to augment the extensor mechanism by securing an Achilles tendon allograft to the proximal part of the patellar tendon and the distal quadriceps tendon using mattress sutures. This serves to reinforce the extensor mechanism and decrease the risk of a tear of its patellar attachment. The patellar bone defect is grafted using corticocancellous bone chips. Results: Over a 12- to 48-month follow-up, all reconstructions healed with an increase in patellar bone thickness. No patient had any extensor lag, and all patients achieved 110°-125° of flexion. The Western Ontario and McMaster University knee scores improved from 53 (23-88) preoperatively to 88.5 (66-100) at last follow-up, with no reported complications. Conclusions: Augmentation of the extensor mechanism with an Achilles tendon allows for early mobilization and excellent postoperative range of motion in patients with large patella bone defects and imminent patella fracture. Level of evidence: IV. Springer-Verlag Berlin Heidelberg, 2014 Revision nationallicence Total knee arthroplasty nationallicence Patella nationallicence Bone grafting nationallicence Hanssen nationallicence Boettner Friedrich Hospital for Special Surgery, 535 East 70th Street, 10021, New York, NY, USA aut Monsef Jad Hospital for Special Surgery, 535 East 70th Street, 10021, New York, NY, USA aut Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/4(2015-04-01), 1035-1038 0942-2056 23:4<1035 2015 23 167 https://doi.org/10.1007/s00167-014-2845-4 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00167-014-2845-4 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Boettner Friedrich Hospital for Special Surgery, 535 East 70th Street, 10021, New York, NY, USA aut NATIONALLICENCE 700 1- Monsef Jad Hospital for Special Surgery, 535 East 70th Street, 10021, New York, NY, USA aut NATIONALLICENCE 773 0- Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/4(2015-04-01), 1035-1038 0942-2056 23:4<1035 2015 23 167