Traumatic Closed Floating Kneecap: Clinical Case about Traumatic Bipolar Tendon Rupture of Extensor Knee System

Sam, Koné; Dom, Pemboura; Eric, Dogba; Koffi, Akue Gerard; Bana, A.; Serge, Agoh

doi:10.4236/ojo.2019.98017

Cited by 2 publications

(5 citation statements)

References 7 publications

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Section: Discussionsupporting

confidence: 83%

“…9 The previous 3 cases reported similar outcomes to our case, with documented knee flexion ranging from 100° to 135° at the final follow-up. 5,6,9…”

Section: Discussionsupporting

confidence: 83%

“…9 The previous 3 cases reported similar outcomes to our case, with documented knee flexion ranging from 100°to 135°a t the final follow-up. 5,6,9 Overall, bifocal knee extensor mechanism rupture at the patellar attachments of the patellar and quadriceps tendons, or floating patella, is a rare presentation documented with varying mechanisms of injury, surgical repair techniques, and functional recovery. In this report, we propose a modification to an…”

Section: Discussionsupporting

confidence: 83%

“…In 2019, Sam et al presented the case of a 33-year-old man with rupture of the quadriceps tendon, patellar tendon, and anterior cruciate ligament after an athletic injury. 9 The previous 3 cases reported similar outcomes to our case, with documented knee flexion ranging from 100°to 135°a t the final follow-up. 5,6,9 Overall, bifocal knee extensor mechanism rupture at the patellar attachments of the patellar and quadriceps tendons, or floating patella, is a rare presentation documented with varying mechanisms of injury, surgical repair techniques, and functional recovery.…”

Section: Discussionsupporting

confidence: 83%

“…This case report presents a bifocal injury to the knee extensor apparatus where both the patella and quadriceps tendons were fully torn along with a superior pole avulsion fracture of the patella. Although multiple ruptures to the ipsilateral quadriceps and patellar tendons are rare, similar injuries have been documented previously 3,5-9 . Kang et al proposed a classification system for bifocal knee extensor apparatus injuries with 5 types: (1) rupture of the patellar tendon at the tibial tubercle with avulsion of the tibial tubercle, (2) rupture of the patellar tendon at the tibial tubercle with avulsion of the inferior pole of the patella, (3) rupture of the quadriceps tendon at the superior pole of the patella with avulsion of the tibial tubercle, (4) avulsion of the inferior pole of the patella with avulsion of the tibial tubercle, and (5) avulsion of the patella and quadriceps tendons directly from their patellar attachments.…”

Section: Discussionsupporting

confidence: 70%

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Tear of Quadriceps and Patellar Tendon with Superior Pole Avulsion of Patella

Kelmer

Johnson

Turcotte

et al. 2023

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Case: A 58-year-old man presented with right knee pain and inability to extend the knee after falling. magnetic resonance imaging (MRI) demonstrated complete rupture of the quadriceps tendon, avulsion of the superior pole patella, and a highgrade partial tear of the proximal patellar tendon. Surgical dissection revealed that both tendon tears were full-thickness disruptions. Repair was performed without complications. The patient achieved independent ambulation and passive range of motion from 0°to 118°at 3.8 years postoperatively.Conclusions: We present a case of a simultaneous ipsilateral tear of the quadriceps and patellar tendons with superior pole patella avulsion that resulted in a clinically successful repair. Extensor mechanism disruption of the knee due to complete tendon rupture of the quadriceps tendon occurs in 1.3% of the US population annually and rupture of the patellar tendon occurs in less than 0.5% 1,2 . Both injuries are more common in men; however, rupture of the patellar tendon is more common before 40 years while quadriceps tendon rupture is positively correlated with age 1,2 . Risk factors of tendon ruptures include chronic inflammation, chronic renal disease, hyperparathyroidism, diabetes mellitus, rheumatoid arthritis, and systemic lupus erythematosus 1,2 . Early diagnosis and surgical repair of these injuries is essential to optimize recovery and functionality. 1,2 Bifocal disruption of the knee extensor mechanism, or floating patella, is an uncommon injury and is more sparsely documented in the literature 3 . We present a case of simultaneous ipsilateral rupture of the quadriceps and patellar tendons with superior pole avulsion of the patella that resulted in a clinically successful repair.Written consent for publication was obtained from the patient. Case ReportA 58-year-old man presented to the emergency department with right knee pain and inability to straighten his right leg after a fall directly onto the anterior aspect of his knee.Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSCC/C44).

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Section: Discussionsupporting

confidence: 83%

“…9 The previous 3 cases reported similar outcomes to our case, with documented knee flexion ranging from 100° to 135° at the final follow-up. 5,6,9…”

Section: Discussionsupporting

confidence: 83%