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.