Extensor apparatus reconstruction with Leeds-Keio ligament in total knee arthroplasty.

The outcome of reconstruction of patellar tendon rupture in total knee arthroplasty has not been particularly good. Five cases of extensor mechanism rupture in total knee arthroplasty are presented. The surgical technique consisted of suture of the extensor apparatus augmented by a Leeds-Keio ligament. Active extension of -10 degrees was achieved by all the patients with flexion of 90 degrees or more. One superficial infection developed, which required antibiotic treatment. In the course of time, the reconstruction elongated less than 1 cm without significantly affecting function. Although the numbers are small and the complications significant, the final results of this technique have been reasonable. The technique permits early weight bearing and immediate mobilization, which enables an adequate range of motion to be achieved.