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

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 (CatonDeschamps 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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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