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to improve exposure in difficult cases or revisions. Purpose: The purpose of this study is toshow the outcome of new technique for repair of overstretched patellar ligament during totalknee arthroplasty. Patients and method: This is retrospective case series study for fourteenpatients who had over stretched patellar ligament during difficult total knee arthroplasty. Tenpatients had less than 50% partial injury of patellar ligament while four patients had more than50% injury for the patellar ligament. four anteroposterior drill holes arranged in two rows weredone from the tibial tuberosity to the medullary canal at the site of tibial component stem. No. 5Ethibond sutures were passed in form of two loops that encircle the patellar ligament like asleeve and left untied. The cemented tibial component was inserted then the suture loops weretied from distal to proximal while the knee in 90 degree flexion so as the ligament was anchoredto the bone. Results: The mean follow up of these cases was 38± 2.6 STD months. Activeextension to -5 degrees was achieved by all patients while the mean flexion range was 100± 4.8STD. None of the patients had delayed rupture of the patellar ligament during follow up.Conclusion: The technique described was effective to regain normal extensor mechanismfunction after partial injury of the patellar ligament during TKA. It can be used as aprophylactic method against delayed rupture of the ligament when the ligament is overstretchedduring difficult cases of TKA.FiguresFigure 1Friday, October 8, 2010, 8:40-9:30Session A11: Knee Arthroplasty in the Middle EastBackgroundConstrained Condylar Arthroplasty in Severe Varus Deformity*Wael Osman - University - Cairo, Egypt*Email: waelbehairy@yahoo.comStandard implants (PCL retaining or posterior stabilized types ) can be used if soft tissuebalancing techniques allow the implant to tension and stabilize the joint in flexion andextension. In severe varus, Greater constraint implant may be used. The indications for the useof these components were inability to balance the knee in both flexion and extension because ofsevere deformities or intraoperative incompetence of the medial collateral ligament afteraggressive release.Material and methodsfourteen patients with twenty knees had severe varus deformity with average preoperative tibiofemoralangle 25°. The average age was 56 years (from 48 to 64). There was nine males andfile:///E|/ISTA2010-Abstracts.htm[12/7/2011 3:15:47 PM]