This retrospective case series compares two tensioning techniques for extensor mechanism allograft reconstruction after total knee arthroplasty: minimal tensioning (7 patients) versus tight tensioning in full extension (13 patients), with minimum 24-month follow-up. The allograft consisted of tibial tubercle, patellar tendon, patella, and quadriceps tendon. The paper also presents the authors' full surgical technique in detail.
When performing extensor mechanism allograft reconstruction after TKA, the single most important technical variable is tensioning the graft tightly in full extension throughout the proximal repair — loose tensioning produces uniform clinical failure with severe extensor lag regardless of other technique details.
Concurrently address any component malrotation, as residual maltracking will place excess stress on the allograft and drive early failure.
This retrospective case series compares two tensioning techniques for extensor mechanism allograft reconstruction after total knee arthroplasty: minimal tensioning (7 patients) versus tight tensioning in full extension (13 patients), with minimum 24-month follow-up. The allograft consisted of tibial tubercle, patellar tendon, patella, and quadriceps tendon. The paper also presents the authors' full surgical technique in detail.
When performing extensor mechanism allograft reconstruction after TKA, the single most important technical variable is tensioning the graft tightly in full extension throughout the proximal repair — loose tensioning produces uniform clinical failure with severe extensor lag regardless of other technique details.
Concurrently address any component malrotation, as residual maltracking will place excess stress on the allograft and drive early failure.