Patellar reconstruction in primary total knee arthroplasty using bone chips from routine cuts: A case report and review of literature

Figure 1 Pre-operative physical examination. It shows valgus misalignment in the left knee on the coronal view.

Figure 2 Pre-operative X-rays. A and B: It shows severe valgus osteoarthritis in the anteroposterior view (A) and the absence of the patella with areas of tendon calcification (orange arrow) in the lateral view (B).

Figure 3 The picture illustrates the localization of the tendon incision to create an intra-tendon pocket (dashed line).

Figure 4 The picture demonstrates the fitting of autogenous bone chips from the remaining routine cuts into the intra-tendon pocket.

Figure 5 Immediate postoperative X-rays. A: It demonstrates good alignment of total knee arthroplasty in the anteroposterior view; B: In the lateral view, the neo-patella evidence is filled with bone chips (dashed circle), giving the appearance of a fragmented patella.

Figure 6 Post-operative clinical image. It was taken at five months showing complete recovery of knee extension.

Figure 7 Two-year follow-up. A: No signs of prosthesis loosening are apparent in either the anteroposterior or lateral views; B: Moreover, in the lateral view, there is no evidence of neo-patellar resorption; instead, it shows an improved shape closely resembling the native patella. It is important to note that the patella appears slightly higher, although this does not manifest as clinical instability.