A systematic approach to reconstruction of neglected tears of the

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patellar tendon. A case report. Mandelbaum-BR; Bartolozzi-A; Carney-B UCLA School of Medicine, Division of Orthopaedic Surgery 90024. Clin-Orthop. 1988 Oct(235): 268-71 Neglected tears of the patellar tendon due to loss of active extension remain a difficult therapeutic endeavor. The goals in the approach to this diagnosis include restoration of both structural and functional integrity of the extensor mechanism. A procedure has been developed utilizing Z-shortening of the patellar tendon, Z-lengthening of the quadriceps tendon, and the semitendinosis gracilis as a biologic splint. This technique allows establishment of preoperative goals, including restoration of the muscle-tendon complex in its anatomic position, restoration of quadriceps function, preservation of vascularity of the reconstructed tendon, and splinting of the patellar tendon. This reconstruction allows early mobilization and rehabilitation.