Abstract Purpose Patellar tendon (PT) disruption following primary total knee arthroplasty (TKA) is an uncommon but devastating complication, with current available surgical options reporting fair to poor long‐term results. We report our experience using the quadriceps tendon autograft with patellar bone block and semitendinosus augmentation (QTPBSTA) as an alternate graft option, at a mean follow‐up of 6.9 ± 3.6 years. Methods This retrospective study cohort included 29 patients with isolated PT ruptures following primary TKA with unresurfaced patellae, between January 2010 and December 2023, treated using the QTPBSTA technique. The diagnosis was confirmed using ultrasonography in 21 patients and magnetic resonance imaging in 8 patients. All the patients were retrospectively evaluated for outcomes at a midterm follow‐up. Data collection included pre‐ and post‐operative extensor lag, Oxford Knee Score (OKS), Knee Society Score (KSS), pre‐ and post‐operative ambulatory status and post‐operative complications. All evaluations were done by an independent physiotherapist. Results Patients treated with this technique achieved reproducible and predictable midterm outcomes with no reported failures and minimal donor site morbidity at a mean follow‐up of 6.9 3.6 years. Of the 29 patients, 8 had no extensor lag, and 21 had a mean lag of 4.2 ± 3.2°. This was a significant improvement from a mean preoperative lag of 66.2 ± 36.4° ( p value < 0.001). Patients with PT ruptures operated within 3 months (early) of the index surgery demonstrated less extensor lag compared with those where intervention was undertaken after 3 months (late) (3.3 ± 2.4° vs. 9.0 ± 2.2°). This graft construct did not deteriorate over time. Conclusion QTPBSTA is a viable alternative for reconstruction of the ruptured PT following primary TKA. Midterm follow‐up at 6.9 ± 3.6 years demonstrated good outcomes, and it may be considered as a reliable option in PT disruption following TKA. The biggest strength of this technique has been a significant reduction in extensor lag. Level of Evidence Level IV.
Rajgopal et al. (Wed,) studied this question.