Reconstruction of a ruptured patellar tendon using ipsilateral semitendinosus and gracilis tendons with preserved distal insertions: two case reports

Takazawa, Yuji; Ikeda, Hiroshi; Ishijima, Muneaki; Kubota, Mitsuaki; Saita, Yoshitomo; Kaneko, Haruka; Kobayashi, Yohei; Sadatsuki, R.; Hada, S.

doi:10.1186/1756-0500-6-361

Cited by 23 publications

(26 citation statements)

References 14 publications

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“…1 Previously many surgical techniques have been proposed to reconstruct the extensor mechanism of the knee. [7][8][9] A study proposed one-stage ALT with vascularized fascia lata to reconstruct a complex knee defect with a deficiency of the patellar tendon. 3 Although this study revealed favorable functional recovery, the isometric power test at 30 flexion of the quadriceps indicated an 80% deficit.…”

Section: Discussionmentioning

confidence: 99%

Reconstruction of massive knee defects with extensor mechanism deficiency through concurrent anterolateral thigh flap and autogenous hamstring tendon: A report of two cases

Liu

Chang

et al. 2020

J Orthop Surg (Hong Kong)

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Reconstruction of an infected knee joint with a large defect and extensor mechanism deficiency is challenging. In this study, we aim to describe a one-stage reconstruction surgery and provide its surgical outcome. Two patients had patellar open fracture and subsequent septic arthritis; in addition, a large soft tissue defect, loss of patella, and shortening of the patellar tendon were observed. The semitendinosus–gracilis tendon formed a loop to stabilize the patella. A free or supercharged reverse pedicle myocutaneous anterolateral thigh flap with fascial extension is designed to fill the defect and eradicate the infection. Mean clinical follow-up was 18 months. Although some limitation in the knee range of motion was observed, the dynamometer showed only partial loss in peak concentric power and eccentric power. We developed an innovative surgical procedure to alleviate infection and reconstruct a complex knee defect with extensor mechanism deficiency; this procedure resulted in favorable clinical outcomes.

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Section: Discussionmentioning

confidence: 99%

Reconstruction of massive knee defects with extensor mechanism deficiency through concurrent anterolateral thigh flap and autogenous hamstring tendon: A report of two cases

Liu

Chang

et al. 2020

J Orthop Surg (Hong Kong)

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“…Some techniques also prescribe a criss-crossing of the graft in a figure-of-8 manner over the anterior surface of the patella and the patella tendon. 5 , 8 Criss-crossing of the graft leads to a higher tension load at points over the patella and along the patellar tendon, which in turn could cause a potential repair failure. In this sense, the Porto technique achieves a U-shaped graft fixation, transmitting the tension load along the retinaculum and through the graft to the anterior tibial tubercle when the knee is flexed.…”

Section: Discussionmentioning

confidence: 99%

“…Commonly observed complications due to tunnelling include patellar fracture, damage to patellar articular cartilage and patella alta or baja as a result of overtightening or undertightening. 7 In addition, a figure-of-8 placement of the graft 5 , 8 can cause a concentration of tension load over the patellar tendon and consequent repair failure. Our Porto technique describes a method of augmentation with the semitendinosus graft, which ensures a complete repair of the patellar tendon while avoiding a transosseous tunnel and, consequently, complications above.…”

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confidence: 99%

Augmentation of Patellar Tendon Repair With Autologous Semitendinosus Graft—Porto Technique

Espregueira-Mendes

Andrade

Michael

et al. 2017

Arthroscopy Techniques

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Patellar tendon ruptures can lead to significant functional deficiency of the extensor mechanism of the knee. These injuries, because of their inherent nature and associated complications, may require a complex treatment and remains a challenge for orthopaedic surgeons. Current surgical techniques present significant complications, including patellar fracture, damage to patellar articular cartilage, and abnormal patella height. This note describes a surgical technique to provide an additional reinforcement to the patellar tendon repair with a semitendinous autograft, without the necessity to perform any transosseous tunnels at the patella bone. First, the patellar tendon is repaired with an end-to-end technique and the semitendinous tendon is harvested. A transosseous tunnel at the tibial tubercle is drilled and 2 rents are made, both medial and lateral to the retinaculum at the level of the intermedial segment of the patella close to the patellar margin. The graft is passed through the tunnel and rents in a U-shaped form. The graft is sutured along the length of the patellar tendon on both margins in tension at 30° of knee flexion. Fluoroscopy imaging is performed to assess the patella height. This technique provides a significant augmentation of patellar tendon, avoiding the potential patella bone tunnel complications.

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“…Transmission of the load from the patella to the tibial tuberosity and allows for appropriate patellar tracking on knee flexion. Most importantly, early mobilization and rehabilitation is possible as this technique avoids post-operative casting [ 25 ]. Our report differs in that they describe a hamstrings autograft.…”

Section: Discussionmentioning

confidence: 99%

Bilateral patellar tendon reconstruction using LARS ligaments: case report and review of the literature

Talia

Tran

2016

BMC Musculoskelet Disord

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BackgroundAcute bilateral patellar tendon rupture is a rare occurrence, with only 1 case reported in the English literature of a young, fit athlete with no regular medications. To our knowledge this is the first such case reported using a LARS reconstruction.Case presentationA 26-year-old otherwise well ex-olympic gymnast with bilateral acute on chronic patellar tendon rupture underwent reconstruction using LARS ligaments. At four years post-operatively he has maintained full range of motion and strength, without re-rupture or any evidence of synovitis.ConclusionThe use of LARS ligament for reconstruction of the patellar tendon is a viable and effective option for rupture. It avoids donor site morbidity associated with autograft. Reconstruction of both patellar tendons simultaneously in a young, elite-level athlete has not previously been reported in the English-language literature.

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Reconstruction of a ruptured patellar tendon using ipsilateral semitendinosus and gracilis tendons with preserved distal insertions: two case reports

Cited by 23 publications

References 14 publications

Reconstruction of massive knee defects with extensor mechanism deficiency through concurrent anterolateral thigh flap and autogenous hamstring tendon: A report of two cases

Reconstruction of massive knee defects with extensor mechanism deficiency through concurrent anterolateral thigh flap and autogenous hamstring tendon: A report of two cases

Augmentation of Patellar Tendon Repair With Autologous Semitendinosus Graft—Porto Technique

Bilateral patellar tendon reconstruction using LARS ligaments: case report and review of the literature

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