Heterotopic ossification after patellar tendon repair in a man with trisomy 8 mosaicism: a case report and literature review

Abstract

IntroductionHeterotopic ossification is the abnormal formation of lamellar bone in soft tissue. Its presence jeopardizes functional outcome, impairs rehabilitation and increases costs due to subsequent surgical interventions.Case presentationWe present a case of a 32-year-old African-American man with trisomy 8 mosaicism who developed severe heterotopic ossification of his right extensor mechanism subsequent to repair of a patellar tendon rupture.ConclusionTo the best of our knowledge there are no prior reports of heterotopic ossification as a complication of patellar tendon repair. This case may suggest an association between trisomy 8 mosaicism and increased risk of heterotopic ossification.

Patellar tendon ossification after anterior cruciate ligament reconstruction using bone – patellar tendon – bone autograft

“…A rare and interesting report was described by Chen et al, an extensive heterotopic ossification after patellar tendon repair in a 32-year-old African-American man with a rare trisomy 8 mosaicism. These authors suggested an association between trisomy 8 mosaicism and increased risk of heterotopic ossification [10]. …”

Synovectomy induced patellar tendon ossification in patient with rheumatoid arthritis: A case report and review of the literature

“…2nd patient - 10 years follow-up, pain free with full ROM. 9 2017, Damrow [ 6 ] 16/male 1 4 × 0.5 cm 2 × 0.5 cm Sleeve fracture of the patella 3-years Surgical excision & patellar tendon reconstruction with semitendinosus tendon autograft & V-Y advancement of the quadriceps tendon 9 months follow-up, asymptomatic 10 1993, Bruijn [ 3 ] 12/female 14/male 2 __ Sleeve fracture of the patella 12-weeks 6-months 1st patient - surgical excision & patellar tendon reconstruction 2nd patient - conservative 1st patient - return to full activity after 6 months 2nd patient - asymptomatic 11 2011, Chen [ 17 ] 32/male b 1 __ Post-operative patellar tendon repair 3-months Knee joint arthrodesis __ 12 2017, Majeed H. [ 13 ] 79/male a 1 3.4 × 2.3 cm 2.9 × 2.2 cm Traumatic patellar tendon injury 49-years Surgical excision & primary repair 6 months follow-up, pain-free with 5 to 100° ROM. 13 2019, Supreeth [ 15 ] 13/male 1 4.5 × 2 × 1 cm 3 × 1.5 × 0.7 cm Traumatic patellar tendon injury 6-weeks Surgical excision & patellar tendon primary repaired with semitendinosus autograft augmentation 6 months follow-up, asymptomatic with full ROM.…”

“…If the remaining tendon is not sufficient to support the extensor mechanism after lesion resection, reconstruction with autograft or synthetic graft is recommended [ 6 , 15 , 16 ]. In cases of massive ossification with a risk of re-ossification and a non-functional joint, arthrodesis may be a salvage option [ 17 ]. Many authors recommended NSAID usage after surgical resection as a HO prophylaxis.…”

Patellar Tendon Reconstruction Using Autologous Hamstring Tendons for the Treatment of Extensive Patellar Tendon Ossification

“…Previous studies have reported patellar tendon ossification associated with antegrade or retrograde femoral nailing, 1 , 2 spinal cord injury, 3 partial patellectomy, 4 anterior cruciate ligament reconstruction (ACLR) using a bone‐patellar tendon‐bone graft (BPTB), 5 , 6 sleeve fractures of the patella or tibial tuberosity, 7 and genetic disorder. 8 Currently, there is no consensus regarding the standard treatment for patellar tendon ossification, especially when extensive ossification occurs that may require surgical intervention. We herein present a case of severe patellar tendon ossification treated with patellar tendon reconstruction utilizing ipsilateral semitendinosus and gracilis autografts.…”