Hyung Suk Choi1, Byung-Woong Jang2, Dong-Il Chun1, Yong Beom Kim1, Gi-Won Seo3, Jinyeong Hwang1, Byung Ill Lee4. 1. Department of Orthopaedic Surgery, Soonchunhyang University Hospital Seoul, 59, Daesagwan-ro, Yongsan-gu, Seoul, 04401, Korea. 2. Department of Orthopaedic Surgery, Soonchunhyang University Hospital Seoul, 59, Daesagwan-ro, Yongsan-gu, Seoul, 04401, Korea. testhoril@gmail.com. 3. Department of Orthopaedic Surgery, Soonchunhyang University Hospital Gumi, Gumi, Korea. 4. Department of Orthopedic Surgery, Smarton Hospital, Bucheon, Korea.
Abstract
BACKGROUND: Patellar tendon rupture is a relatively rare injury that usually requires surgical treatment. The optimal therapeutic strategy is still controversial, especially when either concomitant patellar tendon infection or soft tissue infection surrounds the patellar tendon. Until recently, most reported reconstruction methods are extensive and difficult to apply because of the poor condition of the soft tissue surrounding the patellar tendon. CASE PRESENTATION: A 19-year-old male patient presented to our clinic three weeks following a motorcycle accident. There was a 5 x 4 cm sized skin defect with soft tissue infection below the inferior pole of patella. We performed a staged patellar tendon reconstruction using a doubled bone-patellar tendon-bone allograft (BPTB) to the infected patellar tendon rupture, following local random fasciocutaneous flap and split-thickness skin graft. Three months following surgery, the patient was able to perform an active knee motion with no extension lag and excellent clinical functional result. DISCUSSION AND CONCLUSIONS: Our technique introduced in this specific case is a relatively simple method to reconstruct chronic patellar tendon defects with limited incision exposing only the patellar tendon areas. We expect it can be less invasively performed on patients who have a soft tissue problem and cannot have extensive surgery.
BACKGROUND:Patellar tendon rupture is a relatively rare injury that usually requires surgical treatment. The optimal therapeutic strategy is still controversial, especially when either concomitant patellar tendon infection or soft tissue infection surrounds the patellar tendon. Until recently, most reported reconstruction methods are extensive and difficult to apply because of the poor condition of the soft tissue surrounding the patellar tendon. CASE PRESENTATION:A 19-year-old male patient presented to our clinic three weeks following a motorcycle accident. There was a 5 x 4 cm sized skin defect with soft tissue infection below the inferior pole of patella. We performed a staged patellar tendon reconstruction using a doubled bone-patellar tendon-bone allograft (BPTB) to the infected patellar tendon rupture, following local random fasciocutaneous flap and split-thickness skin graft. Three months following surgery, the patient was able to perform an active knee motion with no extension lag and excellent clinical functional result. DISCUSSION AND CONCLUSIONS: Our technique introduced in this specific case is a relatively simple method to reconstruct chronic patellar tendon defects with limited incision exposing only the patellar tendon areas. We expect it can be less invasively performed on patients who have a soft tissue problem and cannot have extensive surgery.
Authors: Douglas Mello Pavão; Thiago Alberto Vivacqua; Fernando Carneiro Werneck; José Leonardo Rocha de Faria; Marcos de Castro Moreirão; Victor Elias Titonelli; Rodrigo Pires E Albuquerque; Eduardo Branco de Sousa Journal: Arthrosc Tech Date: 2022-07-14