Abstract
We report a case of a full-thickness necrosis of the anterior skin of the patella while harvesting bone-patellar tendon-bone（BTB）with the KOH BTB Harvester（KOH device）.
A 20-year-old male underwent reconstructive surgery of the anterior cruciate ligament of the right knee at the orthopedic surgery department of our hospital. After the operation, the patient was referred to our department because whitening of the anterior skin of the right patella was noted.
The patient was initially followed up with conservative management. However, as necrosis progressed, debridement was performed 14 days after the surgery. On the 27th day after the surgery, a skin flap was applied from the right lateral thigh. Postoperatively, there was no motor function deficit.
To date, there have been no reports of burns caused by the use of a KOH device. As the KOH device is used for osteotomy of the patella subcutaneously, frictional heat is generated subcutaneously during osteotomy. In the present case, due to equipment issues, osteotomy required three-times as long as normal, leading to the burn. Therefore, when using the KOH device, it is necessary to take measures to shorten the contact time with the heat source.
