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Volume 2011, Article ID 545104, 8 pages
Research Article

Alloplastic Reconstruction of the Extensor Mechanism after Resection of Tibial Sarcoma

1Orthopaedic Center for Musculoskeletal Research, Department of Orthopaedic Surgery, König-Ludwig-Haus, Julius-Maximilians-University Würzburg, Brettreichstraße 11, 97074 Würzburg, Germany
2Clinic for Orthopaedic Surgery and Traumatology, Klinikum Rechts der Isar, Technical University Munich, Ismaninger Str. 22, 81675 Munich, Germany
3Department of Precision- and Micro-Engineering, Engineering Physics, Munich University of Applied Sciences, Lothstraße 34, 80335 Munich, Germany

Received 12 December 2010; Accepted 9 February 2011

Academic Editor: Charles Scoggins

Copyright © 2011 Boris Michael Holzapfel et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Reconstruction of the extensor mechanism is essential for good extremity function after endoprosthetic knee replacement following tumor resection. Only a few biological methods have been able to reliably restore a functional extensor mechanism, but they are often associated with significant complication rates. Reattachment of the patellar tendon to the prosthesis using an alloplastic patellar ligament (Trevira cord) can be an appropriate alternative. In vivo and in vitro studies have already shown that complete fibrous ingrowth in polyethylene chords can be seen after a period of six months. However, until now, no biomechanical study has shown the efficacy of an alloplastic cord and its fixation device in providing sufficient stability and endurance in daily life-activity until newly formed scar tissue can take over this function. In a special test bench developed for this study, different loading regimes were applied to simulate loads during everyday life. Failure loads and failure modes were evaluated. The properties of the cord were compared before and after physiological conditioning. It was shown that rubbing was the mode of failure under dynamic loading. Tensile forces up to 2558 N did not result in material failure. Thus, using an artificial cord together with this fixation device, temporary sufficient stable fixation can be expected.