Case of total knee arthroplasty for knee osteoarthritis associated with abnormal patellar tendon deformity: a report

There have been no earlier reports of knee osteoarthritis with valgus knee deformity in which the patellar tendon infiltrates the tibial bone marrow instead of attaching to the tibial tubercle. A 73-year-old Asian woman had been undergoing conservative treatment, but the pain gradually worsened, and she was referred to our hospital for TKA. The patient had no specific history of trauma to the knee but had undergone a surgery for gastric cancer 3 years before.

This case report describes a total knee arthroplasty (TKA) performed for the treatment of a primary knee osteoarthritis resulting from a valgus knee joint position attributed to an abnormality of the patellar ligament attachment. During a TKA, the tendon tissue in the tibial medullary canal interfered with the reamer used to prepare for the stem extensions needed to improve the fixation of the component on the tibia, which had a cortical defect. The arthroplasty succeeded, and good clinical results have been maintained over the 3 years since the surgery. Surgeons should consider careful preoperative examinations by magnetic resonance imaging or CT when an abnormal bone defect is observed at the tibial tubercle on plain X-ray images.

Reference:

Satoshi Miyamoto, Shin Sasaki, Hiroyuki Kojin, Ken Okazaki, Total knee arthroplasty for knee osteoarthritis associated with abnormal patellar tendon deformity: a case report, Journal of Surgical Case Reports, Volume 2024, Issue 3, March 2024, rjae102, https://doi.org/10.1093/jscr/rjae102