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Reconstruction of chronic patellar tendon rupture with contralateral bone-tendon-bone autograft

Knee Surgery, Sports Traumatology, Arthroscopy volume 25, pages 2468–2473 (2017)Cite this article

Abstract

Purpose

To evaluate the clinical and functional outcome following the reconstruction of chronic patellar tendon ruptures using the contralateral bone-tendon-bone (BTB) autograft.

Methods

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.

Results

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.

Conclusions

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.

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Authors and Affiliations

  1. Hospital Madre Teresa, Av. Raja Gabáglia 1002, Gutierrez, Belo Horizonte, Minas Gerais, 30430-142, Brazil

    Eduardo Frois Temponi & Lúcio Honório de Carvalho Júnior

  2. Centre Orthopedic Santy, FIFA Medical Center of Excelence, Ramsay-Générale de Santé, Hôpital Privé Jean Mermoz, Hôpital Privé Jean Mermoz, Lyon, France

    Nuno Camelo, Sanesh Tuteja, Mathieu Thaunat, Jean Marie Fayard & Bertrand Sonnery-Cottet

  3. Kansas City University, Kansas City, MO, USA

    Matt Daggett

Authors
  1. Eduardo Frois Temponi
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  2. Nuno Camelo
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  3. Sanesh Tuteja
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  4. Mathieu Thaunat
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Correspondence to Eduardo Frois Temponi.

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None of the following authors or the departments with which they are affiliated have received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article.

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Temponi, E.F., Camelo, N., Tuteja, S. et al. Reconstruction of chronic patellar tendon rupture with contralateral bone-tendon-bone autograft. Knee Surg Sports Traumatol Arthrosc 25, 2468–2473 (2017). https://doi.org/10.1007/s00167-015-3951-7

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  • DOI: https://doi.org/10.1007/s00167-015-3951-7

Keywords

  • Patellar tendon rupture
  • Chronic injury
  • Autograft
  • Reconstruction
  • Bone-tendon-bone