Fig. 1 ©1994 British Editorial Society of Bone and Joint Surgery 0301-620X/94/2688 $2.00 200 THE JOURNAL OF BONE AND JOINT SURGERY RECONSTRUCTION OF THE EXTENSOR APPARATUS OF THE KNEE WITH THE LEEDS-KEIO LIGAMENT

We describe a new method for the reconstruction of ruptures of the patellar ligament or the quadriceps tendon, using the flexible open-weave polyester Leeds-Keio prosthetic ligament. Of 25 operations performed since 1985, we were able to review 18 patients (19 knees) with a mean follow-up of 3.5 years (3 to 6.5). No patient had required immobilisation of the knee after operation and the average period to return to normal activities without a walking aid was 10.5 weeks. The average range of motion was 146#{176},and four patients could squat fully in the Japanese style. There was an extension lag (< 10#{176})in only four patients; eight patients had some patellar crepitus which was mildly painful in three. There were no cases of infection, persistent joint effusion or rerupture of the extensor apparatus. J BoneJoint Surg [Br] 1994; 76-B:200-3. Received 16 March 1993; Accepted l7June 1993 Rupture ofthe extensor apparatus ofthe knee is an uncommon but severe injury which has a long recovery period and often leaves an extension lag and limitation offlexion. No previous surgical procedure has allowed early return to activity and full function. We report a new operation for the reconstruction of the knee extensor apparatus using the Leeds-Keio artificial ligament. PATIENTS AND METhODS The new procedure has been performed on 25 knees in 24 patients since February 1985. There were 17 men and seven women; their average age was 37.5 years. In 12 knees (11 patients) pathological rupture was secondary to renal failure