Purpose: This study highlights the pattern of presentation, treatment, early functional outcome, and complications observed in the management of chronic patellar tendon ruptures using our preferred technique of autogenous semitendinosus graft reconstruction.
Methods: This was a retrospective case series involving consecutive patients who underwent patellar tendon reconstruction and met the inclusion criteria. The outcome measures were determined by the post-operative knee range of motion (R.O.M), the post-operative International Knee Documentation Committee (IKDC) score, and pattern of post-operative complications.
Results: Nine patients were included in this case series. The mean age of the patients was 35.4 ± 6.8 years (range 27-44 years). Trauma to the knee accounted for majority of the cases (62.5%). Six (66.7%) of the nine patients suffered a patellar tendon rupture from contact injury during sporting activities. The mean length of time from injury to presentation was 20.5 ± 11.2 weeks (range 6-69.5 weeks). Normal knee function in a case (11.1%), nearly normal knee function in 7 cases (77.8%), and abnormal knee function in a case (11.1%) were recorded as a measure of outcome of surgery. The mean post-operative IKDC score was 70.0 ± 6.1 (range 55-77), which was higher than the mean pre-operative score of 26.4 ± 5.1 (range 18-32). The post-operative knee R.O.M averaged 97.2 ± 16.2° (range 70-120°) with a single case with a 10° extension lag noted.
Conclusion: Normal to near-normal knee function was obtained with the treatment of chronic patellar tendon rupture in the majority of cases using autogenous semitendinosus graft for patellar tendon reconstruction in our series.
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http://dx.doi.org/10.1007/s00590-024-04044-z | DOI Listing |
Arthrosc Tech
December 2024
Department of Orthopaedics, University Hospital of Florence - A.O.U. Careggi, Florence, Italy.
Revision of anterior cruciate ligament reconstruction presents various challenges not encountered in the primary settings, including malpositioned tunnels, tunnel widening, and the lack of consensus on the ideal graft to be used. This Technical Note describes a one-stage anterior cruciate ligament reconstruction revision using a bone-patellar tendon-bone autograft combined with lateral extra-articular tenodesis. This technique represents the ideal approach to tackle complex revision cases primarily characterized by tibial and femoral tunnel osteolysis and rotational knee instability.
View Article and Find Full Text PDFArthrosc Tech
December 2024
Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, U.S.A.
The medial patellofemoral complex provides the primary static restraint to lateral patellar translation and is composed of the medial patellofemoral ligament and medial quadriceps tendon femoral ligament. Multiple techniques including medial patellofemoral ligament and/or medial quadriceps tendon femoral ligament reconstruction have demonstrated good results; however, modification of the femoral fixation technique is required for skeletally immature patients or revision cases in which anatomic bony fixation on the femur is not possible. This technique describes an all-soft-tissue procedure for single-bundle medial patellofemoral complex reconstruction in which the graft is fixed on the adductor tendon while using the medial collateral ligament as a distalizing pulley, for anatomic and isometric recreation of the native ligament.
View Article and Find Full Text PDFZhongguo Zhen Jiu
January 2025
Department of Rehabilitation Medicine, General Hospital of Ningxia Medical University, Yinchuan 750004, China; Key Laboratory of Ningxia Ethomedicine Modernization, Ministry of Education, Yinchuan 750004.
Objective: To observe the clinical effect of internal heat acupuncture therapy for knee osteoarthritis of early to middle stages, and explore its influence on cartilage thickness.
Methods: A total of 44 patients with knee osteoarthritis of early to middle stages were treated with internal heat acupuncture therapy at points (most of them are located at the subpatellar fat pad, both sides of the patellar ligament, the tendon of the quadriceps and the attachment of the medial and lateral collateral ligaments), once a week, a total of 4 weeks of treatment. Before and after treatment, after 3 months of treatment completion (in the follow-up), the visual analogue scale (VAS) score, Western Ontario and McMaster Universities osteoarthritis index (WOMAC) score, frequency of 30-second chair stand test (30sCST), cartilage thickness of femoral intercondylar and knee joint ultrasound score were compared, and the clinical effect was evaluated.
Arthrosc Sports Med Rehabil
December 2024
Department of Orthopaedic Surgery, University of California-San Francisco, San Francisco, California, U.S.A.
Purpose: To use a large nationwide administrative database to directly compare usage, complications, and need for revision stabilization surgery after medial patellofemoral ligament reconstruction (MPLFR), tibial tubercle osteotomy (TTO), and combined MPFLR and TTO (MPFLRTTO).
Methods: The PearlDiver Mariner database was queried for all reported cases of MPLFR, TTO, and combined MPFLRTTO performed between 2010 and 2020 using Current Procedural Terminology codes. Subsets from those cohorts with laterality-specific , , codes for patellar instability were used to evaluate 2-year incidence of infection, stiffness, fracture, and revision stabilization with MPFLR and/or TTO.
Arthrosc Sports Med Rehabil
December 2024
College of Charleston, Charleston, South Carolina, U.S.A.
Purpose: To compare the biomechanics of a drop vertical jump (DVJ) landing task and functional outcomes among patients with anterior cruciate ligament reconstruction (ACLR) with quadriceps tendon (QT) and patellar tendon (PT) autografts.
Methods: Physically active patients who underwent primary ACLR with either a QT or PT autograft were included in this study. All were within 6 months to 2 years after surgery and cleared for return to physical activity.
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