Restoration of Knee Function After Tibial Tubercle Proximalization for Infrapatellar Contracture Syndrome Following Patellar Fracture Surgery

Infrapatellar contracture syndrome (IPCS) is a rare but functionally disabling condition characterized by anterior knee fibrosis and patellotibial impingement. We report the case of a 59-year-old woman who developed IPCS after undergoing tension band wiring for a patellar fracture, presenting with pain, quadriceps weakness, and marked patella baja (Insall-Salvati ratio: 0.377). Proximalization of the tibial tubercle by 15 mm restored patellar height and improved knee flexion from 120° preoperatively to 150° at the one-year follow-up. At two years, the patient achieved full squatting and floor sitting (seiza), with no extension lag, quadriceps strength of 86.4 N (contralateral: 96.6 N), and an improved Timed Up and Go score from 12.89 to 6.86 seconds. Tibial tubercle proximalization may be an effective tendon-sparing option for IPCS with patella baja, enabling restoration of patellar height, improved range of motion, and early rehabilitation without direct tendon manipulation.