Management of extreme patella baja using in-situ hamstring tendon autograft

•We present a difficult case of patella baja following TKR.•This was reconstructed using in-situ ipsilateral hamstring autograft.•Good radiographic and clinical results were obtained.•A review of the literature is presented.

Successful total knee arthroplasty requires a functioning extensor mechanism. Patella baja following total knee arthroplasty can cause extensor mechanism dysfunction and produce poor outcomes. We present a case of severe patella tendon shortening following revision total knee arthroplasty with almost complete ankylosis of the distal pole of the patella to the proximal tibia. This resulted in effective extensor mechanism dysfunction with pain and severely limited knee flexion. We report a novel method of reconstruction of the patella tendon at the time of revision arthroplasty together with the one-year clinical outcome and review of the literature.