Extensor mechanism reconstruction after proximal tibial replacement

M J Oddy, C J Pendegrass, A E Goodship, S R Cannon, T W R Briggs, G W Blunn

Research output: Contribution to journalArticlepeer-review


We developed an in vivo model of the attachment of a patellar tendon to a metal implant to simulate the reconstruction of an extensor mechanism after replacement of the proximal tibia. In 24 ewes, the patellar tendon was attached to a hydroxyapatite (HA)-coated titanium prosthesis. In 12, the interface was augmented with autograft containing cancellous bone and marrow. In the remaining ewes, the interface was not grafted. Kinematic gait analysis showed nearly normal function of the joint by 12 weeks. Force-plate assessment showed a significant increase in functional weight-bearing in the grafted animals (p = 0.043). The tendon-implant interface showed that without graft, encapsulation of fibrous tissue occurred. With autograft, a developing tendon-bone-HA-implant interface was observed at six weeks and by 12 weeks a layered tendon-fibrocartilage-bone interface was seen which was similar to a direct-type enthesis. With stable mechanical fixation, an appropriate bioactive surface and biological augmentation the development of a functional tendon-implant interface can be achieved.

Original languageEnglish
Pages (from-to)873-8
Number of pages6
JournalJournal of Bone and Joint Surgery - British Volume
Issue number6
Publication statusPublished - Jun 2005


  • Animals
  • Bone Neoplasms
  • Bone Plates
  • Bone Transplantation
  • Female
  • Gait
  • Hydroxyapatites
  • Knee Joint
  • Patella
  • Range of Motion, Articular
  • Sheep
  • Tendons
  • Tibia
  • Titanium
  • Weight-Bearing
  • Research Support, Non-U.S. Gov't


Dive into the research topics of 'Extensor mechanism reconstruction after proximal tibial replacement'. Together they form a unique fingerprint.

Cite this