Combined Transosseous and Osteosynthetic Reconstruction of Chronic Patellar Tendon Rupture Using Achilles Tendon Allograft With Bone Block

Patellar tendon (PT) ruptures can substantially diminish the quality of life for patients, imposing significant functional limitations and persistent pain. If left untreated, the tendon presents surgical challenges, including scar tissue development, contracture, muscle atrophy, stiffness, and compromised vascular integrity. This technical note describes a technique using Achilles tendon allograft with bone block fixed to the tibia with tendinous graft limbs passed through patellar bone tunnels. Risky drill tunnels and potentially irritating hardware are avoided, healing surface area for graft incorporation is maximized, supplementary fixation is included, and the length-tension relationship is matched to the contralateral knee.