{
  "abstract": "BackgroundTo report the clinical outcomes in a case of severe osteoarthritis secondary to patellectomy 40 years earlier and successfully treated with the function-preserving strategy via fibrous scar tissue extension in total knee arthroplasty (TKA) and postoperative rehabilitation program.MethodsA 59-year-old male patient presented with severe osteoarthritis secondary to the left patellectomy due to trauma 40 years earlier. Intraoperative exploration revealed dense fibrous scar tissues measuring approximately 4.0 cm × 3.0 cm × 1.5 cm at the original patellectomy site. The patient was treated with a function-preserving strategy involving preservation and reshaping of residual fibrous scar tissue into a fibrous pseudo-patella prior to TKA and postoperative rehabilitation, instead of traditional bony patella reconstruction. The fibrous scar tissues acted as a natural alternative to the patella (fibrous pseudo-patella) through extensive lateral retinaculum release and medial capsular tightening to balance soft tissues, and allowed the further TKA using a semi-constrained prosthesis. Postoperatively, the patient was managed by a rehabilitation program for strengthening the quadriceps femoris muscle. Follow-up visits were conducted at 6 weeks, 3 months, and 1 year.ResultsThe patient benefited from an immediate postoperative pain relief of the knee. Quadriceps strength increased markedly at 6 weeks postoperatively, indicating a full restoration of active knee extension. At the 3-month follow-up, the patient regained functional knee range of motion (ROM) of 0°−120°, and was able to independently squat and stand. The 1-year imaging assessment showed an optimal prosthesis positioning and a stable trajectory of the fibrous pseudo-patella. In addition, the patient presented normal gait patterns at 1 year postoperatively.ConclusionResidual fibrous scar tissues with sufficient volume and biomechanical strength could be shaped into a natural alternative to the patella through soft tissue balancing, and our function-preserving strategy combining semi-constrained TKA with postoperative rehabilitation might realize an effective and safe post-patellectomy recovery.",
  "abstract_shown": true,
  "affiliations": [
    "Sichuan Mianyang 404 Hospital, Mianyang, Sichuan, China",
    "The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China",
    "Army Medical University Xinqiao Hospital Department of Orthopeadics, Chongqing, China"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Zhibing Wang"
    },
    {
      "affs": [
        1
      ],
      "name": "Xingwang Cheng"
    },
    {
      "affs": [
        2
      ],
      "name": "Xia Zhang"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/b77ge8pqhxmw5.bib",
  "cited_by": 0,
  "doi": "10.3389/fsurg.2026.1953154",
  "fulltext_url": "https://www.frontiersin.org/articles/10.3389/fsurg.2026.1953154/full",
  "id": "b77ge8pqhxmw5",
  "issns": [
    "2296-875X"
  ],
  "landing_url": "https://doi.org/10.3389/fsurg.2026.1953154",
  "language": "en",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "RD1-811"
    ],
    [
      "openalex",
      "2746|Total Knee Arthroplasty Outcomes"
    ]
  ],
  "openalex": "W7223379863",
  "pdf_url": "https://www.frontiersin.org/journals/surgery/articles/10.3389/fsurg.2026.1953154/pdf",
  "pmcid": "PMC13739784",
  "pmid": "42996340",
  "published": "2026-10-23",
  "publisher": "Frontiers Media S.A.",
  "ris": "https://research.draconitic.com/paper/b77ge8pqhxmw5.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T13:43:48Z",
      "native_id": "de96092c63334fb9a905d78a5576bf08",
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      "url": "https://doi.org/10.3389/fsurg.2026.1953154"
    },
    {
      "first_seen": "2026-11-09T15:20:34Z",
      "native_id": "MED:42996340",
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      "url": "https://europepmc.org/article/MED/42996340"
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Total Knee Arthroplasty Outcomes",
      "subfield": "surgery"
    }
  ],
  "title": "Reconstruction of a fibrous pseudo-patella in total knee arthroplasty after patellectomy: a function-preserving strategy via intraoperative soft tissue balancing and postoperative rehabilitation– a case report",
  "title_text": "Reconstruction of a fibrous pseudo-patella in total knee arthroplasty after patellectomy: a function-preserving strategy via intraoperative soft tissue balancing and postoperative rehabilitation– a case report",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T15:20:34Z",
  "url": "https://research.draconitic.com/paper/b77ge8pqhxmw5",
  "venue": "Frontiers in Surgery",
  "versions": []
}