Delayed Repair with Augmentation using Achilles Allograft of Old Ruptured Patellar Tendon after Revison Total Knee Arthroplasty: A Case Report / 대한정형외과학회잡지

The rupture of the patellar tendon after total knee arthroplasty (TKA) is rare but serious complication resulting in a severe dysfunction in the extension mechanism. There are a few reports on the treatment of this condition. However, there is still some controversy regarding the choice of proper management. There is no report of the patellar tendon augmentation or reconstruction in this condition in the Korean literature. We report a case of an old patellar tendon rupture in 70-year old patient that occurred at 5 months after a two stage revision for an infected TKA and was treated satisfactorily by delayed repair with augmentation using an Achilles allograft.

Reconstruction of Neglected Patellar Tendon Rupture with Achilles Tendon Allograft: A case report

Neglected rupture of patellar tendon is an uncommon event. These rupture is often difficult to repair for structural and functional integrity of extensor mechanism because they generally accompanied quadriceps muscle contracture and a great deal of scar tissue formation. We report a case of neglected rupture of patellar tendon that was treated with achilles allograft. The patient who previously treated conservatively by long leg cast immobilization around the knee joint. He had an unstable knee. MRI showed a neglected rupture of patellar tendon, posterior cruciate 1igament and popliteus tendon. At first, patellar tendon was reconstructed using achilles allograft. Secondary operative procedure was necessary for combined pos-tero-lateral corner injuries. 3 years later, he had regained 130 degrees of flexion and full active extension. He had 3cm of thigh atrophy. He had returned to all of his usual activities without significant instability. There were several treatment methods of neglected rupture of patellar tendon. Achilles tendon allograft was one of them. We experienced this method is sufficient for regain usual extensor mechanism of the knee joint.

Achilles Allograft Reconstruction of a Chronic Patellar Tendon Rupture: A Case Report / 대한정형외과학회잡지

Chronic ruptures of the patellar tendon are uncommon injuries. They are technically difficult to repair because of scar formation, poor quality of the remaining tendon, and quadriceps muscle atrophy and contracture. We report a case on the reconstruction of a chronic patellar tendon rupture. The reconstruction was performed 18 months after the injury, using an Achilles tendon allograft and reinforcing suprapatellar wire. At four weeks postoperative, the patient had attained 70degrees C flexion and 10degrees C extension lag. Nine months after the index procedure, the patient regained 130degrees C flexion and 5degrees C extension lag, and 85% quadriceps strength. The technique accomplished the preoperative goals of restoring quadriceps function and anatomic position of the patella as well as allowing early mobilization after surgery. Although this reconstructive procedure is technically demanding, the functional results obtained can be excellent. We recommend the use of this technique for chronic patellar tendon ruptures that cannot be primarily repaired.