Reconstruction of chronic patellar tendon rupture using graft from contralateral patella graft together with reinforcement from flexor tendons. Case report

Abstract

Chronic patellar tendon rupture is a rare disabling injury that is technically difficult to repair. The true prevalence of this injury is unknown. Delayed reconstruction of chronic patellar tendon rupture has yielded suboptimal clinical and functional results. Many different surgical methods for reconstruction of chronic patellar tendon injury have been reported. In this report, we present a case with chronic patellar tendon injury that was addressed using a technique that had not previously been described in the literature, through combining procedures that had been described separately. The reconstruction method presented in this article has the advantages of being easy and reproducible, without a requirement of allografts.

Clinical Outcomes are Similar Between Graft Types Used in Chronic Patellar Tendon Reconstruction: A Systematic Review

“…Forty-eight studies were sent for data extraction after the screening process (Fig 1). Two studies were excluded because of insufficient reporting of patient demographics and outcomes, 18,33 two studies were excluded due to inadequate follow-up, 6,16 and 35 studies were excluded due to being level V evidence, 4,5,7,[9][10][11][12][13]15,[17][18][19][20]22,24,25,[27][28][29][30][31][33][34][35][36][37][38][39][40][41][42]44,[46][47][48][49][50] leaving 9 studies for inclusion in our review. 3,8,14,21,23,26,32,…”

“…Forty-eight studies were sent for data extraction after the screening process ( Fig 1 ). 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 Two studies were excluded because of insufficient reporting of patient demographics and outcomes, 18 , 33 two studies were excluded due to inadequate follow-up, 6 , 16 and 35 studies were excluded due to being level V evidence, 4 , 5 , 7 , 9 , 10 , 11 , 12 , 13 , 15 , 17 , 18 , 19 , 20 , 22 , 24 , ...…”

Surgical Technique to Bring Down the Patellar Height and to Reconstruct the Tendon for Chronic Patellar Tendon Rupture

“…Because these techniques are relatively difficult, a safe and easy technique to lower the patellar height using polyethylene tape for chronic patellar tendon rupture has been developed. In terms of the reconstruction method, contralateral bone-tendon-bone graft, 7 ipsilateral semitendinosus tendon graft, 8 , 9 Achilles tendon allograft, 10 , 11 and an artificial ligament have been used. 7 , 8 , 10 , 11 , 12 , 13 In this technique, reconstruction was performed with the LK artificial ligament.…”

“…For instance, surgeons need to choose between 1- and 2-stage reconstruction. 5 , 6 Furthermore, contralateral bone-tendon-bone graft, 7 ipsilateral semitendinosus tendon graft, 8 , 9 Achilles tendon allograft, 10 , 11 and an artificial ligament have been used to reconstruct the patellar tendon. 12 Generally, primary repair is not indicated for chronic patellar tendon rupture because of proximal patellar migration, poor quality of the remaining tendon, bone atrophy of the patella, and tissue scarring.…”

Long-Term Outcome After Surgical Treatment of Acute and Chronic Quadriceps Tendon Rupture

“…Due to proximal migration and contracture of quadriceps muscle, surgical treatment is technically very difficult, and functional outcome following the delayed surgery of the knee extensor mechanism is suboptimal (1,5). However, favorable outcome of QTR reconstruction even 8 years after occurrence is reported (4, 6).…”