Failed Knee Extensor Mechanism Repair following Infection: Arthrodesis as a Salvage Path of Management

REPORTstrain near the site of tendon insertions, resulting in a tear near the insertion into bone. 4nderstanding the biomechanics of a tear is critical.While most of the literature had a different opinion.The most commonly accepted is an eccentrically loaded quadriceps muscle while the knee is under hyperflexion.It is presumed that 17.5 times a person's body weight is needed to rupture the patellar tendon IntroductIonPatellar tendon injuries are not so uncommon in men in their third or fourth decade, and prior systemic conditions can be debilitating to the tendon integrity. 1Treatment protocol varies based on the type, viz., complete or partial.Various surgical treatment for these injuries includes direct repair with sutures, transosseous tunnels, and suture anchors. 1 In a chronic condition, whenever the tendon cannot be adequately repaired, reconstruction can be achieved with various allograft and autograft options.If there is failure in the above techniques, or when the patella is severely deformed, necrotic, infected, or the tendon is retracted severely, or there is a higher chance for graft failure, the mainstay of treatment will be an arthrodesis.Additional indications may include prior patellectomy with severe extensor lag, severe patella baja, and severe extensor ossification.The patellar tendon constitutes the distal perspective of the extensor component and expands from the distal pole of the patella to the tibial tubercle.By definition, it is a tendon or may be a ligament since it originates from bone to bone or may be from muscle to bone.However, it is commonly alluded to as a ligament since it is condensed from the quadriceps tendon and distally attached to the tibial tubercle. 1arlier studies have shown the differences in tendon stress and strength on the basis of their insertion.Tensile stresses recorded from cadavers had an upward spike in the anterior portion and a fall in the posterior portion throughout knee flexion. 2 In comparison to the yield stress, the anterior portion of the tendon has higher stress than the posterior portions. 3There is a three-fourths increment in