Table 1.

Advantages and Limitations of Technique

Advantages

The technique is safe and reproducible.

Vertical patellar screws limit the risk of fracture, especially in osteopenic bone and allow passage of suture tape.

Load sharing is improved by suturing the Achilles allograft directly to quadriceps tendon.

Bone-to-bone healing of the calcaneal bone block to the native tibia is reliable.

Ability to secure the suture tape to a post in the tibia.

Limitations

The chronic, and often retracted, nature of these injuries requires extensive exposure.

Quadricepsplasty can result in extensor lag.

Extended period of immobilization required to ensure construct integrity can result in stiffness in knee flexion.

Cannot be used in cases of total knee arthroplasty or with deficient patella bone.