Mesh Reconstruction of Extensor Mechanism for Fracture Nonunion of the Patella in an Osteoarthritic Knee.

For extensor mechanism deficiency in the osteoarthritic knee, mesh reconstruction of the extensor mechanism is an accessible option. Studies have shown that its rates of infection and graft failure are noninferior compared to allograft reconstruction. This case report presents a 51-year-old patient who presented with chronic fracture nonunion of the inferior pole of the patella, associated with pain, extension lag, and osteoarthritis. Since the anterior knee was previously treated with partial-thickness skin graft, soft tissue reconstruction was performed prior to mesh reconstruction of the extensor mechanism and total knee arthroplasty so as to allow later mobilization of underlying muscles. The two-staged operation resulted in improved range of motion, pain levels, and walking tolerance, highlighting the importance of preoperative planning.