Abstract
Background
Patellar ligament rupture is an uncommon but devastating complication of total knee arthroplasty. Many predisposing factors may lead to rupture of the ligament during or shortly after surgery. The most common predisposing factor is extensive release of the ligament to improve exposure in difficult cases or revisions.
Purpose
The purpose of this study is to show the outcome of new technique for repair of overstretched patellar ligament during total knee arthroplasty.
Patients and method
This is retrospective case series study for fourteen patients who had over stretched patellar ligament during difficult total knee arthroplasty. Ten patients had less than 50% partial injury of patellar ligament while four patients had more than 50% injury for the patellar ligament. four anteroposterior drill holes arranged in two rows were done from the tibial tuberosity to the medullary canal at the site of tibial component stem. No. 5 Ethibond sutures were passed in form of two loops that encircle the patellar ligament like a sleeve and left untied. The cemented tibial component was inserted then the suture loops were tied from distal to proximal while the knee in 90 degree flexion so as the ligament was anchored to the bone.
Results
The mean follow up of these cases was 38± 2.6 STD months. Active extension to -5 degrees was achieved by all patients while the mean flexion range was 100± 4.8 STD. None of the patients had delayed rupture of the patellar ligament during follow up.
Conclusion
The technique described was effective to regain normal extensor mechanism function after partial injury of the patellar ligament during TKA. It can be used as a prophylactic method against delayed rupture of the ligament when the ligament is overstretched during difficult cases of TKA.
