D.SD. is a 39 year old with long standing patellofemoral malalignment. He underwent a distal tibial tubercle osteotomy. A non-union at the osteotomy site developed , and was treated by revising the fixation 6 months post op. Over the next year he gradually lost range of motion of his knee, and had increasing pain. The flexion is 60*.
The bone scan shows only mild uptake, and no evidence for infection or reflex sympathetic dystropy.The x-ray at this point showed patella baja.