Chronic patellar tendon rupture. Reconstruction with gracilis and semitendinosus tendon autografts

Abstract

ABSTRACT

Introduction: Neglected rupture of the patellar tendon is a rare pathology and is a challenge for its surgical resolution. The migration of the patela, fibrosis at the site of rupture and the impossibility of facing the ends of the tendon make its first repair impossible having to resort to its reconstruction with graft.

This work describes the reconstruction of the patellar tendon semitendinosus and gracilis autograft, surgical technique based on the work of Ecker and Col.⁶ and Van der Zwaal and Col.^8,with some modifications.

Results: Eight patients, all male, were involved with an average age of 38 years (22-50). Whose time lapse between the rupture and the surgical procedure was on average 60 days (87 – 40). The postoperative follow-up was on average 11 months (7 – 18).

All achieved full knee extension and an average active flexion of 130 degrees (125-140 degrees). The result was excellent in six of them and good in two patients. Lisholm's post-operative score was 92 (90-96). In the radiographic evaluation they had an average Insall–Salvati index of 1.16 (1.1 – 1.3). These last two results were statistically significant (p < 0.005) compared to preoperative.

Conclusion: The neglected rupture of the patellar tendon is a rare pathology, whose surgical resolution is a challenge for the orthopedic surgeon, the technique described in this work offers safety in the reconstruction of this ligament, and offers a complete recovery of the extensor mechanism.

Type of study: Case series, retrospective

Evidence level: IV

Keywords: Tendon lesions, neglected rupture of the patellar tendon, reconstruction of the patellar tendon, semitendinosus and gracilis graft