Chhajed BB, Mehta MA, Prajapati A. A Novel and Effective Surgical Technique for Reconstruction of Extensor Mechanism with Iliotibial Band Tendon Graft After Patellectomy for Primary Patella Tumor.
Indian J Orthop 2024;
58:1310-1315. [PMID:
39170664 PMCID:
PMC11333392 DOI:
10.1007/s43465-024-01190-8]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 05/22/2024] [Indexed: 08/23/2024]
Abstract
Background
Amongst primary patella tumor Campanacci grade 3 tumor of Giant cell tumor of bone (GCTB) and malignant tumors requires patellectomy. We had a patient with huge recurrent GCTB of patella with involvement of skin. We reconstructed extensor mechanism of Knee with long iliotibial band (ITB) tendon graft.
Material and Methods
After patellectomy, we harvested long ITB graft (length 22 cm; width proximally 6 cm, distally 1.5 cm) through patellectomy wound and small "L" shaped incision proximally. We passed ITB graft from patella tendon and quadriceps tendon in figure of 8 manner and sutured it back to itself and host tendon with fiber Wire and closed both the wounds primarily. We started ROM and quadriceps strengthening in graded manner. We measured functional outcome with Musculoskeletal Tumour Society (MSTS) scoring system.
Results
There were no post-operative complications. At 10 weeks follow up, patient had no extension lag and knee ROM was 90°. At final follow up of 7 months patient regained pre-operative functional status without knee instability. Her MSTS score was 30 and she was disease free.
Conclusion
Reconstruction of extensor mechanism of knee with ITB graft doesn't have donor site morbidity and gives excellent function with graded physiotherapy protocol.
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