Davide Cucchi1,2, Alberto Aliprandi3, Elisabetta Nocerino3,4, Pietro Randelli5,6. 1. Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Mangiagalli 31, 20133, Milan, Italy. d.cucchi@gmail.com. 2. U.O. Ortopedia II, IRCCS Policlinico San Donato, Piazza Malan 1, 20097, San Donato Milanese, Milan, Italy. d.cucchi@gmail.com. 3. Servizio di Radiologia, IRCCS Policlinico San Donato, Piazza Malan 1, 20097, San Donato Milanese, Milan, Italy. 4. Università degli Studi di Milano, Via Festa del Perdono 7, 20122, Milan, Italy. 5. Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Mangiagalli 31, 20133, Milan, Italy. 6. U.O. Ortopedia II, IRCCS Policlinico San Donato, Piazza Malan 1, 20097, San Donato Milanese, Milan, Italy.
Abstract
PURPOSE: Simultaneous rupture of the patellar tendon (PT) and the anterior cruciate ligament (ACL) is a relatively rare injury. This study offers a comprehensive review of the published reports and presents two cases of simultaneous PT and ACL rupture. METHODS: A systematic review of English literature was performed, and data from two patients who were referred to our institution with simultaneous PT and ACL rupture were collected. Both patients underwent primary arthroscopic ACL reconstruction combined with PT reconstruction and, 1 year after surgery, magnetic resonance imaging (MRI), clinical examination, strength measurement and functional assessment. RESULTS: Fourteen studies (24 patients) were included in the review. A two-stage approach was used in eight cases (33.3%), and in nine the use of arthroscopy was documented (37.5%). Post-operative scores were documented for nine patients (average IKDC 91.2; Lysholm 94.6), and radiological results were provided for seven. In the two newly reported cases, satisfactory functional results were obtained and MRI at 1-year follow-up revealed regular PT and ACL signal. CONCLUSIONS: No consensus has been established for neither a diagnostic nor a therapeutic algorithm for simultaneous PT and ACL ruptures. Early combined arthroscopic treatment leads to good radiological results, accelerated recovery and patient satisfaction; further studies are required to confirm the role of arthroscopy and assess the superiority of a specific technique. LEVEL OF EVIDENCE: Review of level IV and V studies and case series, Level IV.
PURPOSE: Simultaneous rupture of the patellar tendon (PT) and the anterior cruciate ligament (ACL) is a relatively rare injury. This study offers a comprehensive review of the published reports and presents two cases of simultaneous PT and ACL rupture. METHODS: A systematic review of English literature was performed, and data from two patients who were referred to our institution with simultaneous PT and ACL rupture were collected. Both patients underwent primary arthroscopic ACL reconstruction combined with PT reconstruction and, 1 year after surgery, magnetic resonance imaging (MRI), clinical examination, strength measurement and functional assessment. RESULTS: Fourteen studies (24 patients) were included in the review. A two-stage approach was used in eight cases (33.3%), and in nine the use of arthroscopy was documented (37.5%). Post-operative scores were documented for nine patients (average IKDC 91.2; Lysholm 94.6), and radiological results were provided for seven. In the two newly reported cases, satisfactory functional results were obtained and MRI at 1-year follow-up revealed regular PT and ACL signal. CONCLUSIONS: No consensus has been established for neither a diagnostic nor a therapeutic algorithm for simultaneous PT and ACL ruptures. Early combined arthroscopic treatment leads to good radiological results, accelerated recovery and patient satisfaction; further studies are required to confirm the role of arthroscopy and assess the superiority of a specific technique. LEVEL OF EVIDENCE: Review of level IV and V studies and case series, Level IV.
Authors: Christof Hoffmann; Jan Friederichs; Christian von Rüden; Christian Schaller; Volker Bühren; Christoph Moessmer Journal: J Orthop Surg Res Date: 2017-11-13 Impact factor: 2.359
Authors: Petros Ismailidis; Rolf Kernen; Christian Egloff; Corina Nüesch; Annegret Mündermann; Sebastian Andreas Müller Journal: Case Rep Orthop Date: 2020-02-04