Management of Simultaneous Patellar Tendon and Anterior Cruciate Ligament Ruptures—A Systematic Review of Available Literature

Matthews, Alexander H.; Fraser, Ethan J.; Parkinson, Benjamin

doi:10.1097/bot.0000000000001219

Cited by 10 publications

(19 citation statements)

References 18 publications

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“…While only one case reported a knee dislocation on the initial X-rays [9], a dislocation and spontaneous reduction before the consultation could be possible in our case as in all other cases reporting on PT and ACL injury. Rupture of the medial collateral ligament (MCL) was the most frequent (66.0%) ligament injury, and 69.0% of patients had an injury in either one or both menisci [1]. In contrast, to date, there is no report of associated fractures.…”

Section: Discussionmentioning

confidence: 99%

“…PT and ACL rupture or the associated injuries are commonly missed at initial clinical and radiological diagnostics and only diagnosed intraoperatively. Cumulatively, in 43.3% of the reported cases, the ACL or the PT rupture was initially missed [1]. While in these studies, Xrays of the knee in two planes were the standard diagnostic procedure; preoperative CT or MRI was not conducted [8], the PT injury was always directly repaired, while in most reports (75%), the ACL was also addressed surgically.…”

Section: Discussionmentioning

confidence: 99%

“…Simultaneous ipsilateral patellar tendon (PT) and anterior cruciate ligament (ACL) tear is a rare injury. A systematic review in 2018 identified 28 cases in 17 published reports in the English literature [1]. Associated meniscal and ligamentous injuries are common but frequently initially missed [1].…”

Section: Introductionmentioning

confidence: 99%

“…A systematic review in 2018 identified 28 cases in 17 published reports in the English literature [1]. Associated meniscal and ligamentous injuries are common but frequently initially missed [1]. In contrast, to date, there is no report of associated fractures.…”

Section: Introductionmentioning

confidence: 99%

“…Case Reports in Orthopedics procedures (primary PT repair followed by ACL reconstruction) [1]. The rehabilitation scheme differed between reported cases: most authors prescribed some kind of ROM restriction similar to that commonly used after PT reconstructions and in contrast to the early ROM mobilization usually used after ACL reconstruction.…”

mentioning

confidence: 99%

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Clinical and Biomechanical Outcomes of One-Stage Treatment of a Simultaneous Ipsilateral Patellar Tendon and ACL Tear Combined with a Tibial Plateau Fracture: A Case Study

Ismailidis

Kernen

Egloff

et al. 2020

Case Reports in Orthopedics

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Simultaneous ipsilateral patellar tendon (PT) and anterior cruciate ligament (ACL) tear is a rare injury. Associated meniscal and ligamentous injuries are common but frequently initially missed. In contrast, to date, there is no report of associated fractures. We report on a 40-year-old female Caucasian patient presenting with a ski injury resulting in simultaneous ipsilateral patellar tendon and ACL tear combined with a tibia plateau fracture and a medial and lateral meniscus lesion. ORIF of the tibia as well as one-stage primary reconstruction of the PT and ACL and suturing of the menisci was conducted. The final follow-up was 2 years postoperatively. Lower extremity kinematic, kinetic, and muscle activity measurements were conducted. Although the clinical result was excellent, altered joint kinematics went along with large side-to-side difference in hip and knee joint moments during midstance and terminal stance. During weight acceptance, vastus medialis and hamstring muscles showed greater relative activity in the injured than the uninjured side. This case demonstrates the possibility of excellent early and midterm results with a one-stage approach and suitable rehabilitation scheme. Biomechanical measurements could further help evaluate the outcome of the treatments and implications for the development of potential secondary damage.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Clinical and Biomechanical Outcomes of One-Stage Treatment of a Simultaneous Ipsilateral Patellar Tendon and ACL Tear Combined with a Tibial Plateau Fracture: A Case Study

Ismailidis

Kernen

Egloff

et al. 2020

Case Reports in Orthopedics

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Ruptur des M. soleus als Begleitverletzung einer akuten vorderen Kreuzbandruptur

Ubl

Gabler

2020

Arthroskopie

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ZusammenfassungDie Ruptur des vorderen Kreuzbands (VKB) ist eine häufige Verletzung des Kniegelenks und geht oftmals mit Begleitverletzungen einher. Diese können intra- und extraartikuläre Strukturen betreffen. Die Entscheidung zur konservativen oder operativen Versorgung der VKB-Ruptur muss patientenorientiert und unter Beachtung der Begleitverletzungen erfolgen. Der hier vorliegende Fall beschreibt eine 30-jährige Patientin, die sich nach dem Absprung von einer Kletterwand bei der Landung das linke Knie verletzt hat. Die klinische Untersuchung ergab zum positiven Lachman-Test zusätzlich einen Druckschmerz im Bereich des Ursprungs des M. soleus. Die bildgebende Diagnostik mittels Magnetresonanztomographie (MRT) bestätigte die VKB-Ruptur und zeigte eine begleitende Ruptur des M. soleus im Bereich des Ursprungs am Fibulakopf. Nach der operativen Therapie der VKB-Ruptur und konservativer Behandlung der Muskelläsion zeigte die Patientin einen beschwerdefreien Verlauf ohne Instabilitätsgefühl, Bewegungseinschränkung oder Kraftgradminderung bei einem Follow-up bis 6 Monate nach der Operation. Diese seltene Verletzung unterstreicht die protektive Aufgabe des M. soleus bei einbeinigen Landungen und die Wichtigkeit, diesen Muskel im diagnostischen Algorithmus zu berücksichtigen.

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Simultaneous patellar tendon and anterior cruciate ligament rupture: a systematic review, meta-analysis and algorithmic approach

Ismailidis,

Neopoulos,

Egloff

et al. 2024

Arch Orthop Trauma Surg

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Introduction Isolated patellar tendon (PT) or anterior cruciate ligament (ACL) ruptures are common injuries, yet the co-occurrence of both presents a rare challenge for clinicians. The objectives of the study are to document diagnostic and therapeutic approaches, outcomes, and complications of combined PT and ACL injuries and to develop an algorithm to guide clinicians in decision-making. Methods The systematic review und metanalysis was conducted according to the PRISMA guidelines. Studies reporting on simultaneous PT and ACL ruptures were included. Meta-analysis was performed to compare different diagnostic modalities and treatment strategies. Results Thirty-six studies reporting on 56 Patients were included. 88% of patients had a concomitant injury (apart from PT and ACL) to the ipsilateral knee. Part of the diagnosis was missed in 23% of the cases. Performance of MRI significantly reduced the risk of missing a part of the injury (5% with MRI vs 69% without MRI, p < 0.001). Surgical treatment was used only for the PT in 21% of the cases and for the PT and ACL in 77% of the cases (48% one-stage, 52% two-stage surgical treatment). Conclusion Combined ACL and PT rupture is rare, and recognizing its full extent is crucial for successful management. Performing an MRI in PT rupture from high-energy trauma and diagnostic arthroscopy/arthrotomy when MRI is not done is essential. PT ruptures should be treated surgically. For ACL rupture, conservative and operative treatment, one- or two-stage surgery are possible based on the patient's profile and concomitant injuries. Based on the limited available literature, this systematic review provides a diagnostic and therapeutic algorithm to assist in clinical decision-making.

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Management of Simultaneous Patellar Tendon and Anterior Cruciate Ligament Ruptures—A Systematic Review of Available Literature

Abstract: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Cited by 10 publications

References 18 publications

Clinical and Biomechanical Outcomes of One-Stage Treatment of a Simultaneous Ipsilateral Patellar Tendon and ACL Tear Combined with a Tibial Plateau Fracture: A Case Study

Clinical and Biomechanical Outcomes of One-Stage Treatment of a Simultaneous Ipsilateral Patellar Tendon and ACL Tear Combined with a Tibial Plateau Fracture: A Case Study

Ruptur des M. soleus als Begleitverletzung einer akuten vorderen Kreuzbandruptur

Simultaneous patellar tendon and anterior cruciate ligament rupture: a systematic review, meta-analysis and algorithmic approach

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