Boutonniere Deformity of the knee Following Patellectomy: A Case Report / 대한정형외과학회잡지

ABSTRACT

A 60-year-old man visited our hospital complaining of an inability to actively extend his left knee beyond 45 degrees for seven months after a slip down injury. Twenty years earlier he had sustained a falling down injury to the left knee and had undergone a patellectomy due to comminuted patellar fracture. In the operating room, a defect in the patellar tendon was demonstrated. As the knee was flexed, the medial and lateral portions of the defect in the patellar tendon separated and moved posterioly over the femoral condyles, producing a boutonniere effect. The scarred lateral retinacula and vastus lateralis were released, allowing the medial and lateral portions of the patellar tendon to be brought together. These were then reefed and sutured together, forming a cord that rode in the intercondylar notch. Twelve months postoperatively the knee had an active range of motion from 0 degrees through 120 degrees.