Combined Ipsilateral Revision Quadriceps Tendon Repair and Patellar Tendon Allograft Reconstruction Technique for Floating Patella.

Extensor mechanism disruptions of the knee are significant injuries that have the potential to result in pain and dysfunction unless surgically repaired in the acute setting. Subacute or chronic injuries and revision surgery result in added complexity. The floating patella is a rare injury involving an ipsilateral bifocal disruption of the extensor mechanism. In this article, we present our surgical technique for ipsilateral revision quadriceps tendon repair and patellar tendon reconstruction to address a recurrent tear after revision quadriceps tendon repair with a concomitant subacute patellar tendon tear. The technique involves transosseous patellar and tibial tunnels, Achilles tendon allograft, multiple semitendinosus allografts, and biologic augmentation. Knee-spanning external fixation is applied temporarily for additional stability. Careful attention to restoring patellar height, collagen/biologic augmentation for healing, and strong biomechanical fixation are important considerations.