Patellar Tendon Reconstruction for a Chronic Extensor Mechanism Deficit Using an Achilles Tendon Allograft With Hamstring Autograft and Suture Augmentation

Ginesin, Eyal; Wojnowski, Natalia M.; Patel, Ronak M.

doi:10.1016/j.eats.2019.11.020

Cited by 12 publications

(11 citation statements)

References 13 publications

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“…This biological framing should reinforce the reconstruction's long-term stability, bearing in mind the risk of allograft resorption in the long term. As we can see in the case reported by Ginesin et al [ 18 ], the hamstring has many advantages: it protects the allograft reconstruction thanks to its distal attachment, in addition to being a vascularized graft. McNally [ 15 ] also used a hamstring autograft for patellar tendon reconstruction and described a system with two adjustable cortical buttons, thinking that the adjustable suspensory fixation would help distribute the tension and determine the patellar height needed for a functioning knee joint.…”

Section: Discussionmentioning

confidence: 92%

Achilles Tendon Allograft with Semitendinosus Autograft Reinforcement Is a Successful Treatment for Chronic Patellar Tendon Rupture: Report of Two Cases

Regennass¹,

Boissard

Guillou

et al. 2021

Case Reports in Orthopedics

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Rupture of the patellar tendon must be diagnosed urgently because reconstruction of the extensor mechanism produces better results when it is performed in acute conditions. Reconstruction of chronic extensor mechanism rupture on the contrary is very challenging. Several surgical techniques have been described using a variety of graft choices and fixation methods, but the optimal approach is still under debate. We report our experience of two cases of chronic patellar tendon rupture reconstruction using an Achilles tendon allograft reinforced by a vascularized ipsilateral semitendinosus tendon frame. The rapid functional recovery of the range of motion, only three months postoperatively, showed us that this reconstruction technique was effective.

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Section: Discussionmentioning

confidence: 92%

Achilles Tendon Allograft with Semitendinosus Autograft Reinforcement Is a Successful Treatment for Chronic Patellar Tendon Rupture: Report of Two Cases

Regennass¹,

Boissard

Guillou

et al. 2021

Case Reports in Orthopedics

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“…Similarly, in a study of 7 patients, Temponi et al had no failures in patients who underwent reconstruction on average 16 months from their injury; however, none returned to their preinjury functional level 8 . Additional grafts including allografts and synthetic augmentation have also been studied with similar results 5,9,10 . Given the drastic proximal retraction seen in our patient, the Achilles allograft with a calcaneal bone block provided adequate soft tissue for tendon reconstruction while also providing the advantage of bone-to-bone healing.…”

Section: Discussionmentioning

confidence: 99%

Reconstructing a Patellar Tendon Rupture Neglected for 14 Years When Anatomic Restoration Is Not Possible

Jurgensmeier

Kweon

2023

JBJS Case Connector

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Case: This case highlights the utility and outcomes of an Achilles tendon bone-block allograft in reconstructing the patellar tendon of a 44-year-old man in the setting of a high-riding, irreducible patella after a chronic patellar tendon rupture of 14 years. Conclusion: In cases of a neglected patellar tendon rupture with an irreducible high-riding patella, an Achilles tendon bone-block allograft can provide the length and tissue necessary to reconstruct the extensor mechanism. Although reconstruction may not be anatomic, patients can still experience great subjective and objective functional improvement with restoration of the extensor mechanism even after delayed reconstruction.

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“…After complete resection of the invaded patellar ligament, a soft tissue tunnel in the quadriceps tendon and a bone tunnel on the depth of the tibial tubercle were made, respectively. In this step, we avoided drilling bone tunnels in the patella, which was one of the differences from other researchers 8 . This detail could minimize the impact on patellar development in children.…”

Section: Discussionmentioning

confidence: 99%

“…Numerous techniques for patellar ligament reconstruction, including autologous tendon transfer or local transplantation 5 , synthetic materials 6 , and allograft tissue 7 , have been reported. In terms of traditional patellar ligament reconstruction techniques, establishing a bone tunnel on the patella is often required 8 . However, constructing a bone tunnel on the patella of young patients might affect the development of the patella.…”

Section: Introductionmentioning

confidence: 99%

Allogeneic Tendon Transplantation for the Treatment of Pathological Patellar Ligament Defect in Children: Technical Note and 4‐Year Follow‐Up

Zhou

Long

et al. 2022

Orthopaedic Surgery

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Objective The absence of patellar ligament will bring about a severe negative impact on daily life. Many reconstruction techniques have been described in adults. However, there is a lack of technical introduction regarding the reconstruction of the patellar ligament in children. The purpose of this study was to report a surgical technique for reconstructing the patellar ligament in children. Method A retrospective analysis of the clinical data on a patellar ligament (tendon sheath fibroma) patient with allogeneic tendon reconstruction. An 8‐year‐old child with postoperative recurrence of left patellar ligament tumor was enrolled in our study. Anterior tibialis tendon allograft was used to reconstruct the patellar ligament after complete resection of the patellar ligament for the tumor. The tunnels were constructed on the deep surface of the tibial tubercle and the root of the quadriceps tendon (to decrease the harmful impact on patella development), respectively. The allogeneic tendon was passed through the tunnels above in the shape of “8,” and the two ends of the tendon were attached to the bleeding bone bed at the inferior edge of the patella with suture anchors to achieve better bone‐tendon healing. During the follow‐up, the knee's range of motion and imaging manifestations were recorded. Result Postoperative pathology suggests chondromesenchymal hamartoma, a rare benign soft tissue tumor different from the previous operation (tendon sheath fibroma). During the 4‐year follow‐up, the patient's active range of motion of the knee achieved 0° to 120°; and the patient could walk normally without any external help. Physical examinations (the apprehension sign and J sign) showed no ligamentous instability or patellar ligament tenderness. Imaging analysis showed that the ratio length of the patellar ligament to the patella was almost normal. The integrity, continuity, and shape of the allogeneic ligament showed excellent results in MRI. Combined with clinical and imaging findings, allogeneic tendon patellar ligament reconstruction was deemed successful. Conclusion Allogeneic ligament reconstruction technique can provide a treatment option by reconstructing the extensor mechanism, minimizing the impact on patellar development, and augmenting biological healing for children with the absence of the patellar ligament.

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Patellar Tendon Reconstruction for a Chronic Extensor Mechanism Deficit Using an Achilles Tendon Allograft With Hamstring Autograft and Suture Augmentation

Cited by 12 publications

References 13 publications

Achilles Tendon Allograft with Semitendinosus Autograft Reinforcement Is a Successful Treatment for Chronic Patellar Tendon Rupture: Report of Two Cases

Achilles Tendon Allograft with Semitendinosus Autograft Reinforcement Is a Successful Treatment for Chronic Patellar Tendon Rupture: Report of Two Cases

Reconstructing a Patellar Tendon Rupture Neglected for 14 Years When Anatomic Restoration Is Not Possible

Allogeneic Tendon Transplantation for the Treatment of Pathological Patellar Ligament Defect in Children: Technical Note and 4‐Year Follow‐Up

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