Three Cases of Patella Fracture in 1,320 Anterior Cruciate Ligament Reconstructions With Bone–Patellar Tendon–Bone Autograft

Viola, Renato; Vianello, Roberto

doi:10.1053/ar.1999.v15.015009

Cited by 77 publications

(34 citation statements)

References 7 publications

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“…It seems possible, like Shelbourne and Trumper [15] suggested, to decrease the incidence of anterior knee pain with modern accelerated rehabilitation programs. Fracture of the patella is a rare complication and occurs in 0.1–3% of the cases [42,43]. In this study, no patella fracture was reported.…”

Section: Discussionmentioning

confidence: 57%

Femoral press-fit fixation in ACL reconstruction using bone-patellar tendon-bone autograft: results at 15 years follow-up

Widuchowski

Widuchowska

czy

et al. 2012

BMC Musculoskelet Disord

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BackgroundIf anterior cruciate ligament (ACL) reconstruction is to be performed, decision regarding graft choice and its fixation remains one of the most controversial. Multiple techniques for ACL reconstruction are available. To avoid disadvantages related to fixation devices, a hardware-free, press-fit ACL reconstruction technique was developed.The aim of this study was to evaluate clinical outcome and osteoarthritis progression in long term after ACL reconstruction with central third patellar-tendon autograft fixed to femur by press-fit technique.MethodsFifty two patients met inclusion/excusion criteria for this study. The patients were assessed preoperatively and at 15 years after surgery with International Knee Documentation Committee Knee Ligament Evaluation Form, Lysholm knee score, Tegner activity scale and radiographs.ResultsGood overall clinical outcomes and self-reported assessments were documented, and remained good at 15 years. The mean Lysholm and Tegner scores improved from 59.7 ± 18.5 and 4.2 ± 1.0 preoperatively to 86.4 ± 5.6 (p = 0.004) and 6.9 ± 1.4 (p = 0.005) respectively at follow-up. The IKDC subjective score improved from 60.1 ± 9.2 to 80.2 ± 8.1 (p = 0.003).According to IKDC objective score, 75% of patients had normal or nearly normal knee joints at follow-up. Grade 0 or 1 results were seen in 85% of patients on laxity testing. Degenerative changes were found in 67% of patients. There was no correlation between arthritic changes and stability of knee and subjective evaluation (p > 0.05).ConclusionsACL reconstruction with patellar tendon autograft fixed to femur with press-fit technique allows to achieve good self-reported assessments and clinical ligament evaluation up to 15 years. Advantages of the bone-patellar-tendon-bone (BPTB) press-fit fixation include unlimited bone-to-bone healing, cost effectiveness, avoidance of disadvantages associated with hardware, and ease for revision surgery. BPTB femoral press-fit fixation technique can be safely applied in clinical practice and enables patients to return to preinjury activities including high-risk sports.

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Section: Discussionmentioning

confidence: 57%

Femoral press-fit fixation in ACL reconstruction using bone-patellar tendon-bone autograft: results at 15 years follow-up

Widuchowski

Widuchowska

czy

et al. 2012

BMC Musculoskelet Disord

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“…Considerable information is also available in relation to the patella in humans, mainly relating to its fracture (e.g. Viola & Vianello, ; Canizares & Selesnick, ; Mereddy & Hakkalamani, ), which is a relatively common injury. Studies in the field of sports medicine also include patellar tendinopathies (e.g.…”

Section: Sesamoids In Veterinary and Human Medicinementioning

confidence: 99%

Sesamoids in tetrapods: the origin of new skeletal morphologies

et al. 2019

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Along with supernumerary bones, sesamoids, defined as any organized intratendinous/intraligamentous structure, including those composed of fibrocartilage, adjacent to an articulation or joint, have been frequently considered as enigmatic structures associated with the joints of the skeletal system of vertebrates. This review allows us to propose a dynamic model to account for part of skeletal phenotypic diversity: during evolution, sesamoids can become displaced, attaching to and detaching from the long bone epiphyses and diaphysis. Epiphyses, apophyses and detached sesamoids are able to transform into each other, contributing to the phenotypic variability of the tetrapod skeleton. This dynamic model is a new paradigm to delineate the contribution of sesamoids to skeletal diversity. Herein, we first present a historical approach to the study of sesamoids, discussing the genetic versus epigenetic theories of their genesis and growth. Second, we construct a dynamic model. Third, we present a summary of literature on sesamoids of the main groups of tetrapods, including veterinary and human clinical contributions, which are the best-studied aspects of sesamoids in recent decades. Finally, we discuss the identity of certain structures that have been labelled as sesamoids despite insufficient formal testing of homology. We also propose a new definition to help the identification of sesamoids in general. This review is particularly timely, given the recent increasing interest and research activity into the developmental biology and mechanics of sesamoids. With this updated and integrative discussion, we hope to pave the way to improve the understanding of sesamoid biology and evolution.

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“…At final follow up this complication did not affect long-term clinical outcome in either series. 8,35 Other studies have also confirmed that early fracture recognition and internal fixation allows adequate rehabilitation without compromising final clinical outcome. 3,32 Benson et al 2 reported a late avulsion fracture of the superior pole of the patella 1 year after the index reconstruction and 6 months after return to full athletic activities.…”

Section: Patella Fracturesmentioning

confidence: 92%

“…The three postoperative fractures occurred between 1 and 8 weeks postoperatively and all were treated with internal fixation. Viola et al 35 described three displaced transverse patella fractures in a series of 1320 ACL reconstructions. These fractures occurred between 8 and 12 weeks postoperatively and were treated with open reduction and internal fixation with subsequent hardware removal.…”

Section: Patella Fracturesmentioning

confidence: 99%

Extensor Mechanism Macrotraumatic Complications

Risinger¹,

Bush‐Joseph²,

Bach³

2005

Techniques in Orthopaedics

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Summary: Macrotraumatic extensor mechanism complications do occur after central third patellar tendon harvest for anterior cruciate ligament (ACL) reconstruction and include intra-or postoperative patella fracture and patellar tendon rupture. These are significant complications that often require additional surgery. Intraoperative precision when harvesting the patellar tendon, bone grafting the donor sites and implementing contemporary postoperative rehabilitation and bracing protocols may minimize their occurrence.

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Three Cases of Patella Fracture in 1,320 Anterior Cruciate Ligament Reconstructions With Bone–Patellar Tendon–Bone Autograft

Cited by 77 publications

References 7 publications

Femoral press-fit fixation in ACL reconstruction using bone-patellar tendon-bone autograft: results at 15 years follow-up

Femoral press-fit fixation in ACL reconstruction using bone-patellar tendon-bone autograft: results at 15 years follow-up

Sesamoids in tetrapods: the origin of new skeletal morphologies

Extensor Mechanism Macrotraumatic Complications

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