Knee Extensor Mechanism Reconstruction With Medial Gastrocnemius Flap

Distal femur and proximal tibia replacement with megaprosthesis in revision knee arthroplasty: a limb-saving procedure

“…The indication for augmentation with a reattachment tube was adequate soft‐tissue coverage and an aseptic revision. The gastrocnemius rotation flap without tube augmentation was used to reconstruct the patellar ligament when there was inadequate soft‐tissue coverage in septic two‐stage re‐implantation [9, 22]. Reconstructions using the Trevira tube or gastrocnemius rotation flap were immobilized for 4 weeks in an orthopedic brace with full axial weight‐bearing.…”

Wound complications in total knee arthroplasty. Which flap is to be used? With or without retention of prosthesis?

“…In complex soft tissue defects involving the quadriceps or patellar tendon or both, the medial (or lateral) gastrocnemius myotendinous flap can be used to manage the extensor mechanism disruption, providing for functional tendon reconstruction and soft tissue coverage simultaneously [9, 36, 39].…”

Medial Gastrocnemius Flap for Reconstruction of the Extensor Mechanism of the Knee Following High-Energy Trauma. A minimum 5 year follow-up

“…There are also reports of its successful use after both infection of the native knee and chronic osteomyelitis of the tibial tuberosity [5,24]. In this case series loss of the extensor mechanism involved complete detachment of the patellar ligament insertion, with destruction of portions of the ligament in all cases and complete or partial loss of the tibial tubercle in two cases.…”

“…The strength of this technique is due to the fact that the same tissue is being used in the reconstruction to fill two roles. It is simultaneously providing vital soft tissue cover while also restoring the continuity of the extensor mechanism, facilitating re-attachment of the patellar ligament remnants back to the tibial tubercle [3,5,7,15,20,24,26,27].…”