Two-layer repair of a chronic patellar tendon rupture: a novel technique and literature review.

Neglected rupture of the patellar tendon can be a debilitating problem. Various techniques have been described to reconstruct chronic tears. This article presents a simple technique for 2-layer repair of chronic patellar tendon ruptures using Achilles allograft augmentation. A manual laborer presented to the orthopedic clinic 5 years after sustaining an unrecognized patellar tendon rupture. Despite this significant delay between injury and reconstruction, our patient enjoyed excellent range of motion and full quadriceps strength 19 months after reconstruction. We believe our technique provides several advantages. By design, the tibial trough was shallower than the depth of the bone block, thus minimizing patellofemoral contact pressure. Transpatellar drilling with the use of a Beath pin makes suture passage easier and provides strong repair permitting early mobilization. Furthermore, our technique spares the remaining native patellar tendon tissue, preserves its insertions, and does not require the use of a tension cerclage wire.