case_images: PMC3027081_01
case_images: Development of patella infera. 18 months postoperatively, the patella contacts the PE inlay at 60  flexion.
case_images: TOORTHJ-5-17_F1.jpg
case_images: PMC3027081_01_TOORTHJ-5-17_F1.jpg
case_images: F1
case_images: Radiological controls conducted over the further course showed a successive lowering of the patella (Fig. 1).
case_images: Section through a biopsy from the patellar ligament, with only partially retained ligament structures in the form of taut collagenic connective tissue (black arrows). The majority of the sample shows degenerative changes, such as maceration of the fibers, the absence of fibrocytes (white arrows) and small foci of lipomatous transformation (arrow tips). Connective tissue proliferation cannot be seen (hematoxylin-eosin, magnification 200x).
case_images: TOORTHJ-5-17_F2.jpg
case_images: PMC3027081_01_TOORTHJ-5-17_F2.jpg
case_images: F2
case_images: A biopsy of the patellar ligament revealed degenerative changes, with a reduction in cell density and compression of collagen fibers (Fig. 2).
case_images: Postoperative image after change to a partially coupled prosthesis and distalization of the joint line by 5mm.
case_images: TOORTHJ-5-17_F3.jpg
case_images: PMC3027081_01_TOORTHJ-5-17_F3.jpg
case_images: F3
case_images: The joint line was distalized 8mm and the patella was partially resected 8 mm distally (Fig. 3).