Abstract
Compromised patellar bone stock poses significant technical challenges in knee revision surgery. The alternatives that have been proposed include reinsertion of a biconvex patellar component, patellar bone grafting, patellectomy, and leaving the unresurfaced patellar bone remnant in place. Various results have been reported with these methods, but not one of them has yet been widely accepted. A novel sagittal osteotomy that was used in four patients is described. This osteotomy leaves the extensor mechanism intact and allows the medial and lateral halves of the residual patella to hinge open in the shape of a “gull wing.” This conforms to the femoral trochlear groove and when combined with particulate bone grafts, it consolidates as a mass resembling a patella. The procedure has been limited to severe cases and obviates the need for patellectomy.
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