Reconstruction of Acute Patellar Tendon Rupture after Patellectomy

Acute rupture of the knee extensor mechanism after patellectomy is extremely rare. We present the case of a patient with acute patellar tendon rupture who had undergone patellectomy 53 years before. Twelve days after the injury, the ruptured patellar tendon was repaired with end-to-end suture. Postoperatively, we splinted the knee for 6 weeks but permitted the patient to walk without limiting weight bearing at 1 week postoperatively. At one-year follow-up, the patient is able to move his knee almost full range of motion and the Lysholm knee score is 81. The patient is satisfied with the outcome. This is the first report to treat acute rupture of the patellar tendon in a patient who had undergone patellectomy. Although careful rehabilitation is required, end-to-end suture might be an adequate surgical procedure for acute rupture of the knee extensor mechanism after patellectomy.

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Quadriceps reconstruction with suture anchor and Achilles allograft combination in quadriceps tendon re-rupture after primary surgical repair: A novel technique

Joint Diseases and Related Surgery ◽

10.52312/jdrs.2021.14 ◽

2021 ◽

Author(s):

Erhan Okay ◽

Mehmet Cenk Turgut ◽

Abbas Tokyay

Keyword(s):

Suture Anchor ◽

Surgical Repair ◽

Primary Repair ◽

Full Range ◽

Knee Extensor ◽

Quadriceps Tendon ◽

Extensor Mechanism ◽

Surgical Options ◽

Knee Extensor Mechanism

Quadriceps ruptures are one of the pathological conditions of the knee extensor mechanism, accounting for 3% of all tendon injuries. These injuries cause substantial disability of the extensor mechanism. Primary repair is the treatment of choice in acute presentation. In the setting of chronic conditions, the treatment becomes more challenging. Available surgical options include lengthening procedures, and reconstruction with auto graft or allografts. The traditional Scuderi and Codivilla techniques are challenging to perform in degenerative or traumatic retracted ruptures. There is no standard effective treatment in these patients, which yields the best clinical and biomechanical outcomes. An 18 - year-old male patient with quadriceps re-rupture after a primary repair was managed with allograft reconstruction using suture anchors. At six years of follow-up, the patient gained a full range of motion with excellent clinical outcomes. He returned to his previous work. In conclusion, quadriceps reconstruction using suture anchor and Achilles allograft combination is a feasible technique in neglected cases who present with quadriceps tendon re-rupture after primary surgical repair.

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A rare case of patellar fracture with quadriceps tendon rupture

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20210638 ◽

2021 ◽

Vol 7 (2) ◽

pp. 406

Author(s):

K. N. Subramanian ◽

Ganesan G. Ram ◽

Muthukumar S. ◽

Mathiyazhagan Babu

Keyword(s):

Patellar Tendon ◽

Rare Case ◽

Tendon Rupture ◽

Quadriceps Tendon ◽

Extensor Mechanism ◽

Patella Fracture ◽

Patellar Fracture ◽

Quadriceps Tendon Rupture ◽

Patellar Tendon Rupture ◽

Bone Level

<p>Quadriceps tendon rupture is the rarest injury with an incidence of 1.37/1,00,000/year. A patellar fracture is the most common injury associated with extensor mechanism lag, but it is rarely found to have quadriceps rupture rather than patellar tendon rupture. Normally when patella fracture occurs the force is disseminated at the bone level rather than at the muscular level. In this case, the force has disseminated at both muscle and bone leading to fracture of patella and quadriceps tendon rupture. Here we report a case of patellar fracture along with quadriceps tendon rupture.<strong></strong></p>

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Ossified proximal patellar tendon rupture

BMJ Case Reports ◽

10.1136/bcr-2020-235143 ◽

2020 ◽

Vol 13 (7) ◽

pp. e235143

Author(s):

Vishwas Hosur Ravishankar ◽

Khaldoun El Abed ◽

Riaz Ahmad

Keyword(s):

Patellar Tendon ◽

Tendon Rupture ◽

Eccentric Contraction ◽

Progressive Increase ◽

Knee Extension ◽

Extensor Mechanism ◽

Patellar Tendon Rupture ◽

Indirect Injury ◽

The Common ◽

Tendon Pathology

Extensor mechanism injuries are not uncommon in young active individuals. Patellar tendon is a part of extensor mechanism of the knee which is commonly ruptured due to forced eccentric contraction against flexed knee. There have been reports of pathological changes in the patellar tendon which eventually lead to the rupture. The common pathologies include hypoxic tendinopathy, mucoid degeneration, calcific tendinopathy and tendolipomatosis. We report a rare case of ossified proximal patellar tendon rupture in a fit and active skittle player, who sustained indirect injury to knee while playing soccer. The rupture was confirmed on examination and radiographs. We discovered intraoperatively that the ruptured proximal patellar tendon was ossified which was sequentially repaired with two Krackow sutures, JuggerKnot suture anchor and finally augmented with Leeds Keio tape. Postoperatively, a knee brace was used to immobilise in knee extension with progressive increase in range of motion. This report supports the pool of evidence suggestive of patellar tendon pathology in causing ruptures.

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Reconstruction of Patellar Tendon Rupture After Total Knee Arthroplasty With an Extensor Mechanism Allograft

Clinical Orthopaedics and Related Research ◽

10.1097/00003086-199011000-00026 ◽

1990 ◽

Vol 260 ◽

pp. 154-161 ◽

Cited By ~ 117

Author(s):

Roger H. Emerson ◽

William C. Head ◽

Theodore I. Malinin

Keyword(s):

Total Knee Arthroplasty ◽

Patellar Tendon ◽

Knee Arthroplasty ◽

Tendon Rupture ◽

Extensor Mechanism ◽

Patellar Tendon Rupture ◽

Total Knee

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Extensor mechanism repair and reconstruction using Achilles tendon allograft after bilateral patellar tendon rupture in a patient with rheumatoid arthritis

Knee Surgery Sports Traumatology Arthroscopy ◽

10.1007/s00167-009-1021-8 ◽

2009 ◽

Vol 18 (8) ◽

pp. 1113-1115 ◽

Cited By ~ 5

Author(s):

Zimin Wang ◽

Qian Wang ◽

Hao Tang ◽

Yifan Kang

Keyword(s):

Rheumatoid Arthritis ◽

Achilles Tendon ◽

Patellar Tendon ◽

Tendon Rupture ◽

Extensor Mechanism ◽

Patellar Tendon Rupture ◽

Tendon Allograft ◽

Achilles Tendon Allograft

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Achilles Tendon Allograft with Semitendinosus Autograft Reinforcement Is a Successful Treatment for Chronic Patellar Tendon Rupture: Report of Two Cases

Case Reports in Orthopedics ◽

10.1155/2021/9951754 ◽

2021 ◽

Vol 2021 ◽

pp. 1-7

Author(s):

Lucie Regennass ◽

Mathieu Boissard ◽

Alban Fouasson-Chailloux ◽

Ronan Guillou ◽

Cecile Toanen ◽

...

Keyword(s):

Achilles Tendon ◽

Patellar Tendon ◽

Tendon Rupture ◽

Surgical Techniques ◽

Extensor Mechanism ◽

Reconstruction Technique ◽

Patellar Tendon Rupture ◽

Tendon Allograft ◽

Optimal Approach ◽

Achilles Tendon Allograft

Rupture of the patellar tendon must be diagnosed urgently because reconstruction of the extensor mechanism produces better results when it is performed in acute conditions. Reconstruction of chronic extensor mechanism rupture on the contrary is very challenging. Several surgical techniques have been described using a variety of graft choices and fixation methods, but the optimal approach is still under debate. We report our experience of two cases of chronic patellar tendon rupture reconstruction using an Achilles tendon allograft reinforced by a vascularized ipsilateral semitendinosus tendon frame. The rapid functional recovery of the range of motion, only three months postoperatively, showed us that this reconstruction technique was effective.

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Disturbance of Extensor Mechanism after Primary and Revision Knee Arthroplasty

N.N. Priorov Journal of Traumatology and Orthopedics ◽

10.17816/vto20140431-37 ◽

2014 ◽

Vol 21 (4) ◽

pp. 31-37

Author(s):

G. M Kavalerskiy ◽

V. Yu Murylyov ◽

M. Yu Kholodaev ◽

Ya. A Rukin ◽

P. M Elizarov ◽

...

Keyword(s):

Patellar Tendon ◽

Knee Arthroplasty ◽

Tendon Rupture ◽

Extensor Mechanism ◽

High Rate ◽

Patellar Tendon Rupture ◽

Revision Knee Arthroplasty ◽

Primary Arthroplasty ◽

Positive Results ◽

Better Than

Rate of extensor mechanism complications after primary and revision knee arthroplasty reaches 12 %. Description and systematization of such complications by literature data is given. Our experience in treatment of 12 patients with such complications after primary knee and in 5 patients after revision knee arthroplasty that made up 1.0 and 13.9% of all interventions, respectively, is presented. Registered complications include para-patellar scars and ossification impingement (4), patellar lateralization (5), patellar dislocation (1), patellar tendon rupture (7). Treatment results in patients after primary arthroplasty are better than after revision intervention - 83.3 and 40% of positive results, respectively. It is shown that high rate (42.9%) of patellar tendon rupture are associated with deep periprosthetic infection. Besides, autoplasty with m. gracilis and m. semitendinosus shows its inefficiency in treatment of such complications.

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How does patellar tendon advancement alter the knee extensor mechanism in children treated for crouch gait?

Gait & Posture ◽

10.1016/j.gaitpost.2018.06.005 ◽

2018 ◽

Vol 64 ◽

pp. 248-254 ◽

Cited By ~ 7

Author(s):

Moria F. Bittmann ◽

Rachel L. Lenhart ◽

Michael H. Schwartz ◽

Tom F. Novacheck ◽

Scott Hetzel ◽

...

Keyword(s):

Patellar Tendon ◽

Knee Extensor ◽

Extensor Mechanism ◽

Crouch Gait ◽

Knee Extensor Mechanism

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Successful management of bilateral patellar tendon rupture in a dog

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.3415/vcot-07-05-0053 ◽

2008 ◽

Vol 21 (02) ◽

pp. 181-184 ◽

Cited By ~ 10

Author(s):

R. Shahar ◽

R. Joseph ◽

J. Milgram ◽

A. Shipov

Keyword(s):

Patellar Tendon ◽

Tendon Rupture ◽

Steel Wire ◽

Weight Bearing ◽

Tendon Repair ◽

Type I ◽

Patellar Tendon Rupture ◽

Radiographic Findings ◽

Excellent Outcome ◽

History Of

SummaryA seven-year-old, 41 kg, intact, cross breed dog, was presented with a history of bilateral hind limb lameness after falling from a height of 1 m. Clinical and radiographic findings were consistent with bilateral patellar tendon rupture. Surgical repair was performed bilaterally. The tendons were sutured primarily, and an internal splint of nylon leader was added. Good apposition of the severed tendon ends had been achieved intraoperatively; however, post operative radiographs showed supra-trochlear displacement of both patellae. The casts used to immobilize the stifle joints slipped distally and three days post operatively the tendon repair had broken down, bilaterally. Revision surgery was undertaken and the tendons were re-sutured. Nylon leader was placed through holes that had been drilled in the patellae and tibiae. The stifle joints were immobilized with type I external skeletal fixators (ESFs). Both freeform polymethylmethacrylate (PMMA) connecting bars were found to be broken at the level of the stifle joints two days later, without any disruption of the primary tendon repair. Each connecting bar was replaced with two connecting bars of PMMA reinforced with 3 mm steel wire. The dog was fully weight-bearing with a reduced range of motion in flexion immediately after removal of the ESFs at six weeks and was still sound 18 months post-operatively. Primary tendon repair in combination with adequate immobilization allowed for an excellent outcome in a complicated bilateral pathology.

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