Purpose: This study was carried out in order to assess the results of reconstruction of a deficient extensor mechanism in the presence of total knee replacement using Connective Tissue Prosthesis (CTP).

Methods & results: The CTPs are available as flat tapes constructed from polyester in an open weave structure. They were used to reinforce and reconstruct the extensor mechanism which was deficient in three patients who had undergone total knee replacement or were about to undergo total knee replacement. Two cases had extensor mechanism deficiency as a complication following total knee replacement while the third case had extensor mechanism deficiency at the time of the primary knee reconstruction. The average follow-up was one year. All three cases showed good results with no extension lag and good range of movement at follow up.

Conclusion: A Connective Tissue Prosthesis Reconstruction of the knee extensor mechanism offers a good option for the management of the uncommon but difficult problem of extensor mechanism deficiency in patients with a total knee arthroplasty.

We report the long-term results of the surgical treatment of chronic rupture of tendo Achillis using polyester tape. This requires minimal postoperative splintage and allows early mobilisation and a prompt return to work and sport. We reviewed 16 patients (10 women and 6 men) at a mean period of three years after surgery. The median time from injury to operation was 16.8 months (3.9 months to 13 years), and the median age of the patients was 52 years (27 to 78). The median time to full weight-bearing was 40 days and the median time for return to sport was 18 weeks (5.4 to 32). One patient required further surgery and one had numbness along the distribution of the sural nerve. After surgery only two patients had increased dorsiflexion of the ankle compared with the uninjured side. There were no cases of rerupture. We recommend this technique for the treatment of chronic rupture of tendo Achillis.