Results of surgical treatment of the patellar tendon rupture

Abstract

Introduction. The aim of the study was to report surgical treatment results of complete patellar tendon ruptures reconstructed by different surgical procedures. Material and Methods. This study included 35 patients, 26 males and 9 females, with an average age of 39 (range, 16 - 66) years. Seventeen patients had the risk factors (48.6%), including 11 with prior surgeries of the same knee: 7 reconstructions of the anterior cruciate ligament, 3 total knee replacement surgeries, and one intramedullary nailing. In 27 patients (77.1%), the surgery was performed during the first seven days after the injury. The following procedures were applied: patellar tendon repair with suture anchors in 5 cases; 13 transpatellar suturing through transpatellar tunnels; additional strengthening with wires and screws was performed in 7 patients; 7 reconstructions with bone-tendon-bone allograft taken from the bone bank, and in 3 patients contralateral bonetendon-bone autografts were used. Results and Discussion. The average Lysholm score was 86.1 (range, 27 - 100). Excellent results were found in 19 cases (54.2%), satisfactory in 10 (28.6%), and unsatisfactory in 6 patients (17.1%) who had chronic diseases and total knee replacement. The patients with timely diagnosis had significantly better results (90.1) than patients with chronic tendon injuries (72.6 points). Conclusion. Good results of acute rupture reconstruction are achieved by transosseous techniques or suture anchors. The surgery is much more complicated in neglected and chronic ruptures, and the results are worse. Surgical procedures, such as the patellar tendon reconstruction by bone-tendon-bone graft, additionally strengthened with wiring and screws, contribute to stable fixation, enable early rehabilitation, and prevent stiffness and muscle weakness.