Background: Chronic patellar tendon rupture is a rare but very disabling to the knee function. With proper reconstruction techniques good knee function can be restored.

Purpose: To evaluate the outcome of reconstruction of chronic rupture of patellar tendon by Semitendinosus-Gracilis autografts and internal brace augmentation. Study Design: retrospective study; Level of evidence, 3. Methods: Reconstruction was performed for 5 patients with chronic patellar tendon rupture. age was 37 years in Average time since injury was 13 months. active extension was not possible, a quadriceps strength of grade 2/5 and mean an IKDC score of 34. According to IKDC Subjective Knee Evaluation the 5 patients' knees were rated as severely abnormal. All 5 patients underwent reconstruction using a distally based Semitendinosus-Gracilis autografts with internal brace augmentation.

Results: Patients were followed up for 24 months. At 6 months, all patients had full active knee extension. 4 patients had quadriceps power of 5/5 and one patient has a power of 4/5. The IKDC score improved to an average of 82 (range 80–86), In 4 patients the knees were rated as normal while one knee was rated as near normal. All patients returned back to preinjury activity levels. Conclusion: Surgical reconstruction of chronic rupture of patellar tendon utilizing Semitendinosus- Gracilis autografts with internal brace augmentation yields excellent out come and can restore the function and biomechanics of the extensor mechanism of the knee to pre injury levels.