Patellar Tendon Lengthening: Rescue Procedure for Patella Baja

Abstract

Patella baja is a challenging pathologic condition that causes pain and functional restrictions and can even lead to premature osteoarthritisdeven more so in cases of patella infera or cases associated with degeneration of the patellar tendon in which simple conservative treatment frequently is not resolutive. Several surgical options have been described for symptomatic patella baja: excision of the lower third of the patella, lengthening of the patellar tendon, reconstruction of the patellar tendon with allograft, and proximalization of the tibial tubercle. A combination of 2 or more of these treatments may be recommended in cases of significant patella baja. We present a simple and reproducible technique to address patella baja that combines a partial transposition of the tibial tubercle and patellar tendon lengthening using a subperiosteal patellar flap in continuity with the patellar tendon.

An Unusual Cause of Sudden Bilateral Lower Extremity Weakness

“…Plain radiographs are helpful in assessing patella position and ruling out patella avulsions or fractures. An inferior patella, known as patella baja, can be suggestive of a chronic quadriceps tendon rupture (Perelli et al, 2019). MRI, however, remains the diagnostic gold standard and is important for preoperative planning (Meester & Lee, 2018).…”

Chronic Quadriceps Tendon Ruptures: Primary Repair of Quadriceps Via Bioaugmentation and Patellar Tendon Lengthening

“…8 This restoration, guided by the height of the contralateral knee, is performed via lengthening of a pathologically thickened patellar tendon. 9 This procedure is not commonly performed due to concern for disruption of patellar tendon integrity and vascularity. 9 To mitigate these concerns, bioinductive implants are placed at both the boneetendon junction of the quadriceps repair and at the lengthening site on the patellar tendon.…”

“…9 This procedure is not commonly performed due to concern for disruption of patellar tendon integrity and vascularity. 9 To mitigate these concerns, bioinductive implants are placed at both the boneetendon junction of the quadriceps repair and at the lengthening site on the patellar tendon. Augmentation with bioinductive implants has proven to aid in tendon healing in massive rotator cuff tears.…”

Plastia em Z modificada do ligamento patelar com reforço de tendão quadricipital no tratamento da patela baixa

“…[1][2][3][4][5] Está associada a gonalgia crónica, conflito mecânico da patela, insuficiência muscular quadricipital e diminuição da amplitude articular. [1][2][3][4][5][6][7][8][9] Os achados anatomopatológicos chave são o encurtamento e aumento da espessura ligamentar, fibrose intraarticular e da gordura de Hoffa, retração tecidular e fraqueza ou disfunção do músculo quadricipital. [1][2][3][4][5][6][7][8][9] Existem vários métodos radiológicos para avaliar a altura patelar: índice Insall-Salvati, índice Blackburne-Peel e o índice Caton-Deschamps.…”

“…[1][2][3][4][5][6][7][8][9] Os achados anatomopatológicos chave são o encurtamento e aumento da espessura ligamentar, fibrose intraarticular e da gordura de Hoffa, retração tecidular e fraqueza ou disfunção do músculo quadricipital. [1][2][3][4][5][6][7][8][9] Existem vários métodos radiológicos para avaliar a altura patelar: índice Insall-Salvati, índice Blackburne-Peel e o índice Caton-Deschamps. 1,4,5 Na descrição deste caso, os autores utilizaram o índice Caton-Deschamps, sendo que valores <0,6 indicam a existência de patela baixa.…”