Gull-wing osteotomy for the treatment of the deficient patella in revision total knee arthroplasty.

Reconstruction of the deficient patella remains a challenge in revision total knee arthroplasty. Twelve consecutive patients who had a knee revision in which a nonresurfacable patella was treated with a gull-wing patellar osteotomy were followed using a computerized database. Radiographs revealed successful healing of the osteotomy in all patients with central tracking of the patella in the trochlear groove. There was a significant improvement in the range of motion and Knee Society scores. There were no patellar fractures or significant patellar malalignment in this series. This technique has shown promising results for the treatment of the nonresurfacable patella during revision total knee arthroplasty, and we conclude that it is a viable method of patellar salvage reserved for the most advanced cases of patellar bone stock compromise.