Patellar tendon re-rupture management using reconstruction with allograft, proximal and distal bone blocks, and suture augmentation: a case report
DOI:
https://doi.org/10.58814/01208845.48Keywords:
Patellar Ligament, Rupture, Tendon Injuries, AllograftAbstract
Introduction: Patellar tendon rupture is a rare but highly disabling injury due to extensor mechanism involvement, and in most cases it requires surgical management. Ruptures following initial reconstruction (re-rupture) are even less frequent and the literature on their management is limited to case reports.
Case presentation: A 34-year-old man with a history of left patellar tendon rupture visited the emergency room of a quaternary care institution in Bogotá, Colombia, due to sudden pain, edema, and limitation of active extension of the left knee following a direct trauma sustained while practicing sports. An X-ray of the knee taken on admission revealed high patella and confirmed re-rupture of left patellar tendon. Patellar tendon reconstruction was performed using allograft, proximal and distal bone blocks, and augmentation with high-strength sutures, achieving full range of motion, successful return to sports activities, and satisfactory results from the patient’s perspective at one-year follow-up.
Conclusions: The patellar tendon reconstruction technique described herein is an effective alternative to treat patellar tendon re-ruptures, as satisfactory outcomes were obtained in our patient. However, studies with a larger number of patients and longer follow-up periods are required to establish the effectiveness and safety of this surgical technique.
Downloads
References
Clayton RAE, Court-Brown CM. The epidemiology of musculoskeletal tendinous and ligamentous injuries. Injury. 2008;39(12):1338–44. https://doi.org/cmn86k.
Boublik M, Schlegel T, Koonce R, Genuario J, Lind C, Hamming D. Patellar Tendon Ruptures in National Football League Players. Am J Sports Med. 2011;39(11):2436-40. https://doi.org/ddcsdw.
Lee D, Stinner D, Mir H. Quadriceps and Patellar Tendon Ruptures. J Knee Surg. 2013;26(05):301-8. https://doi.org/gf3jqd.
Enad JG. Patellar tendon ruptures. South Med J. 1999;92(6):563-6. https://doi.org/c4nnkt.
Rosso F, Bonasia DE, Cottino U, Dettoni F, Bruzzone M, Rossi R. Patellar tendon: From tendinopathy to rupture. Asia Pac J Sports Med Arthrosc Rehabil Technol. 2015;2(4):99-107. https://doi.org/mhw2.
Gilmore JH, Clayton-Smith ZJ, Aguilar M, Pneumaticos SG, Giannoudis P V. Reconstruction techniques and clinical results of patellar tendon ruptures: Evidence today. Knee. 2015;22(3):148-55. https://doi.org/gf3jrr.
Camarda L, D’Arienzo A, Morello S, Guarneri M, Balistreri F, D’Arienzo M. Bilateral ruptures of the extensor mechanism of the knee: A systematic review. J Orthop. 2017;14(4):445-53. https://doi.org/gbs2cm.
Saragaglia D, Pison A, Rubens-Duval B. Acute and old ruptures of the extensor apparatus of the knee in adults (excluding knee replacement). Orthop Traumatol Surg Res. 2013;99(1):S67-76. https://doi.org/f4pdc5.
Siwek CW, Rao JP. Ruptures of the extensor mechanism of the knee joint. J Bone Joint Surg Am. 1981;63(6):932-7
Hsu KY, Wang KC, Ho WP, Hsu RW. Traumatic patellar tendon ruptures: A follow-up study of primary repair and neuralization wire. J Trauma. 1994;36(5):658-60.
O’Dowd JA, Lehoang DM, Butler RR, Dewitt DO, Mirzayan R. Operative Treatment of Acute Patellar Tendon Ruptures. Am J Sports Med. 2020;48(11):2686-91. https://doi.org/mhw5.
Vajapey SP, Blackwell RE, Maki AJ, Miller TL. Treatment of Extensor Tendon Disruption After Total Knee Arthroplasty: A Systematic Review. J Arthroplasty. 2019;34(6):1279-86. https://doi.org/mhw7.
Maffulli N, Papalia R, Torre G, Denaro V. Surgical Treatment for Failure of Repair of Patellar and Quadriceps Tendon Rupture With Ipsilateral Hamstring Tendon Graft. Sports Med Arthrosc Rev. 2017;25(1):51-5. https://doi.org/gf3jrz.
Moretti L, Vicenti G, Abate A, Pesce V, Moretti B. Patellar tendon rerupture in a footballer: Our personal surgical technique and review of the literature. Injury. 2014;45(2):452-6. https://doi.org/f5pzxw.
Haber DB, Ruzbarsky JJ, Arner JW, Vidal AF. Revision Patellar Tendon Repair With Anchors, Allograft Augmentation, and Suspensory Fixation. Arthrosc Tech. 2020;9(11):e1845-9. https://doi.org/mhw8.
Sutton D, Shybut T. A Suture Anchor-Based Repair Plus Reconstruction Using Acellular Human Dermal Allograft for Recurrent Sports-Related Patellar Tendon Rupture. Arthrosc Tech. 2021;10(4):e1089-93. https://doi.org/mhxb.
Vadalà A, Iorio R, Bonifazi AM, Bolle G, Ferretti A. Re-revision of a patellar tendon rupture in a young professional martial arts athlete. J Orthop Traumatol. 2012;13(3):167-70. https://doi.org/dxm9fb.
Koh BTH, Sayampanathan AA, Lee KT. Patellar tendon re-rupture on the opposite end of the previous site of surgical repair. Indian J Orthop. 2017;51(3):334-6. https://doi.org/f98s4q.
Von Glinski A, Yilmaz E, Rausch V, Königshausen M, Schildhauer TA, Seybold D, et al. Semitendinosus autograft augmentation after bilateral patellar tendon re-rupture: a case report and technique note. Eur J Orthop Surg Traumatol. 2019;29(6):1347-53. https://doi.org/mhxc.
Choi HS, Jang BW, Chun D Il, Kim YB, Seo GW, Hwang J, et al. Staged patellar tendon reconstruction using doubled bone-patellar tendon-bone allograft for infected patellar tendon rupture: a rare case report of three years follow-up. J Exp Orthop. 2021;8(1):4-9. https://doi.org/mhxf.
Moretti L, Vicenti G, Abate A, Pesce V, Moretti B. Patellar tendon rerupture in a footballer: Our personal surgical technique and review of the literature. Injury. 2014;45(2):452-6. https://doi.org/f5pzxw.
Véliz Fuentes PN, Sánchez Alarcón XL, Mariscal Cobos WA, Palma Alvarado LL, Alcívar Reyes MC. Modificación de técnica de Larson y Simonian para reconstrucción de rotura crónica de tendón rotuliano. Ecuador J Med. 2022;5(1):43-8.
Grau Muñoz CA, Sánchez Alarcón XL, Véliz Fuentes PN, Quillupangui Navarro G. Plastia y alargamiento de tendón rotuliano mediante alambre puente en rótula y cosecha autóloga de semitendinoso y gracilis. Reporte de caso clínico. Hospital policía no.2 de Guayaquil, febrero 2018. Rev. Med. UCSG. 2018;22(3):140.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Revista Colombiana de ortopedia y traumatología
This work is licensed under a Creative Commons Attribution 3.0 Unported License.
Derechos de autor
Los autores aceptar transferir a la Revista Colombiana de Ortopedia y Traumatología los derechos edición, publicación y reproducción de los artículos publicados. La editorial tiene el derecho del uso, reproducción, transmisión, distribución y publicación en cualquier forma o medio. Los autores no podrán permitir o autorizar el uso de la contribución sin el consentimiento escrito de la revista. Una vez firmada por todos los autores, la carta de Cesión de derechos debe ser cargada en el paso dos del envío.
Aquellos autores que tengan publicaciones en esta revista aceptan los siguientes términos:
- Los autores/as conservarán sus derechos de autor y garantizarán a la revista el derecho de primera publicación de su obra, el cuál estará simultáneamente sujeto a la Licencia de reconocimiento de Creative Commons que permite a terceros compartir la obra siempre que se indique su autor y su primera publicación esta revista.
- Los autores/as podrán adoptar otros acuerdos de licencia no exclusiva de distribución de la versión de la obra publicada (p. ej.: depositarla en un archivo telemático institucional o publicarla en un volumen monográfico) siempre que se indique la publicación inicial en esta revista.
- Se permite y recomienda a los autores/as difundir su obra a través de Internet (p. ej.: en archivos telemáticos institucionales o en su página web), lo cual puede producir intercambios interesantes y aumentar las citas de la obra publicada. (Véase El efecto del acceso abierto).
