Reconstruction of chronic patellar tendon rupture with contralateral bone-tendon-bone autograft
- 436 Downloads
To evaluate the clinical and functional outcome following the reconstruction of chronic patellar tendon ruptures using the contralateral bone-tendon-bone (BTB) autograft.
The records of seven patients who underwent reconstruction of chronic patellar tendon rupture with contralateral patellar BTB were retrospectively reviewed. Chronic tears were defined as a minimum of 3 months from injury to initial clinical evaluation. Clinical assessments included range of motion of the knee, Tegner, Lysholm and International Knee Documentation Committee (IKDC) score and a radiographic analysis of patellar height (Caton–Deschamps index). Postoperative complications and quadriceps strength at last follow-up were reported.
The mean age of the patients undergoing surgery was 33 (±10.5) years with a mean follow-up of 41.3 (±29.7) months. Reconstruction surgery was performed at an average of 16 months (3–60 months) after the injury. 86 % of the patients had a normal patella height with mean of patellar height of 1.5 (±0.2) in preoperative radiographs and of 1.2 (±0.07) on postoperative evaluation (p = 0.0136). The mean IKDC was 45.5 (±10.8) before surgery and 64.5 (±12.4) at the last follow-up (p = 0.0001), and Lysholm score was 45.4 (±11.3) and 79 (±11.8), respectively (p = 0.0001). The median Tegner activity scale preinjury was 6 (range 5–7), preoperatively was 1 (range 1–2) and 4 (range 2–5) postoperatively (p = 0.0001). All patients had quadriceps wasting with a difference in thigh girth between the injured side and healthy side of 3.6 ± 0.7 cm (ns). No surgical complications were encountered.
In this limited cohort, surgical reconstruction of chronic patellar tendon ruptures using contralateral bone-tendon-bone graft was a safe and viable option that improves clinical and functional outcomes compared to presurgical function. However, despite the restoration of a normal patellar height, function did not return to preinjury level.
KeywordsPatellar tendon rupture Chronic injury Autograft Reconstruction Bone-tendon-bone
Compliance with ethical standards
Conflict of interest
- 18.Rand JA, Morrey BF, Bryan RS (1989) Patellar tendon rupture after total knee arthroplasty. Clin Orthop Relat Res 244:233–238Google Scholar
- 20.Shelbourne KD, Beck MB, Gray T (2015) Anterior cruciate ligament reconstruction with contralateral autogenous patellar tendon graft: evaluation of donor site strength and subjective results. J Bone Joint Surg Am 43(3):648–653Google Scholar
- 25.Takazawa Y, Ikeda H, Ishijima M, Kubota M, Saita Y, Kaneko H, Kobayashi Y, Sadatsuki R, Hada S, Kaneko K (2013) Reconstruction of a ruptured patellar tendon using ipsilateral semitendinosus and gracilis tendons with preserved distal insertions: two case reports. BMC Res Notes 6:361CrossRefPubMedPubMedCentralGoogle Scholar
- 26.Tegner Y, Lysholm J (1985) Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res 198:43–49Google Scholar
- 29.Yang L, Guo L, Dai C, Han XS, Chen GX, Duan XJ, Dai G, Xie F (2007) Bone-patellar tendon-bone graft in anterior cruciate ligament reconstruction: allograft versus autograft. Zhonghuawaikezazhi [Chinese Journal of Surgery] 45(2):82–85Google Scholar