Ruptura atraumática bilateral do ligamento patelar—relato de caso

Juliato, Raul Hernandez; Boschi, Luis Henrique; Juliato, Raul Francisco; Freitas, Americo Pinto de; França, Alexandre Felipe; Bottura, Lourenço Betti

doi:10.1016/j.rbo.2017.12.023

Cited by 4 publications

(3 citation statements)

References 7 publications

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“…One patient had both MRI and ultrasonography as secondary investigations. Only eight cases [2,24,[36][37][38][39][40][41] reported the Insall-Salvati ratio found during imaging. Of those presented, we found a mean Insall-Salvati ratio of 1.62 for the right patella and 1.60 for the left patella, which confirmed that patella alta is a high-yield finding in the diagnosis of patellar tendon rupture.…”

Section: Diagnostic Processmentioning

confidence: 99%

“…The big majority of the cases reported were treated with direct primary repair (40 patients), and over half of these cases required augmentation of some type, i.e., tendons, cerclage wires or tension band wiring [1][2][3]11,12,24,28,37,39,40,41,[46][47][48][49][50][51][52][53][54]. The most commonly used method for augmentation was using cerclage wires (12).…”

Section: Treatmentmentioning

confidence: 99%

“…Single patellar tendon ruptures are relatively uncommon, and bilateral patellar tendon ruptures are even rarer and have scarcely been reviewed in the literature, presenting mostly as low-quality evidence with the odd literature review [1]. These studies highlight specific predisposing risk factors for bilateral patellar tendon ruptures, such as hyperuricemia, lupus erythematosus and hyperparathyroidism, which cause microstructural changes, leading to weakened ligament collagen [2]. However, the causes for tendon ruptures in the literature are predominantly categorised as systemic conditions, chronic microtrauma or steroid use, with only a few studies presenting predisposing factors for degenerative changes of the patellar tendon, and explaining the bilateral and simultaneous nature of this injury remains challenging [3].…”

Section: Introductionmentioning

confidence: 99%

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Simultaneous Bilateral Patellar Tendon Rupture: A Systematic Review

Fernandes,

Rufino,

Hamal

et al. 2023

Cureus

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The extensor mechanism of the knee can be damaged due to various modes of injury, which, in most cases, will require urgent surgical intervention for repair. Single patellar tendon ruptures are uncommon, but simultaneous bilateral events are even rarer and have been scarcely reviewed in English literature. Research in this area is mainly confined to case series, with some literature reviews but no evidence of more substantial analysis. Therefore, this systematic review was done to analyse the existing literature on bilateral simultaneous patellar tendon ruptures and propose a systematic and standardised approach to diagnosing and managing these injuries.A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The search terms included 'bilateral patellar tendon rupture', 'bilateral', 'patellar', 'tendon' and 'rupture'. Three independent reviewers conducted searches in PubMed, OvidSP for Medline, Embase and the Cochrane Library using the same search strategy. The eligibility criteria included studies on bilateral concomitant patellar tendon rupture published in English. Bilateral simultaneous patellar tendon ruptures of traumatic and atraumatic origin in human patients were included. The study types comprised case reports and literature reviews.The key limitation of this study was the low number of patients covered by the eligible literature. Patellar tendon ruptures are a rare and scarcely documented injury, and there is a need for studies with a high level of evidence, especially regarding surgical treatment choice and methods, as well as post-operative management, which could potentially lead to improved outcomes in the management of this injury.

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Section: Diagnostic Processmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Simultaneous Bilateral Patellar Tendon Rupture: A Systematic Review

Fernandes,

Rufino,

Hamal

et al. 2023

Cureus

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Patellar and quadriceps tendon rupture are associated with hip fracture in hemodialysis patients with severe hyperparathyroidism

Pichone,

Juvencio,

Crespo

et al. 2024

JBMR Plus

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Spontaneous rupture of the patellar (PTR) and quadriceps (QTR) tendon are infrequent. Systemic diseases such as diabetes mellitus, chronic kidney disease and secondary hyperparathyroidism (SHPT) are risk factors. The present cohort study aimed to evaluate risk factors associated with tendon rupture in hemodialysis (HD) patients with SHPT, as well as outcomes including surgical complications, re-ruptures and fracture. Baseline clinical, laboratorial data and radiographs were analyzed. Patients were followed up from March 2012 to March 2020. One-hundred thirty-one patients (≥18 years of age, on HD ≥ 6 months, with SHPT) were included. Incidence rates of PTR and QTR were 2.3 and 1.7/10000 HD patients/year, respectively. The mean age of patients with tendon rupture was 44.0 ± 11.2 years. These patients exhibited higher serum levels of phosphorus (6.3 ± 1.5 mg/dL vs 5.6 ± 1.1 mg/dL; p = 0.005), parathyroid hormone (2025.7 ± 667.6 pg/mL vs 1728.4 ± 684.8 pg/mL; p = 0.035), and C-reactive-protein (35.4 ± 32.9 mg/dL vs 17 ± 24.5 mg/dL; p = 0.002) compared to the group without tendon rupture. The mean follow-up was 56.7 ± 27.1 months. No patient required a new surgical approach or experienced re-rupture. Of all patients, 31% experienced hip fracture: 50% in the group with rupture (29.5 ± 17.4 months after the tendon rupture) vs 26% without tendon rupture (p = 0.015). After adjustment, the hazard ratio for hip fracture was 2.87 (CI 95% 1.27–6.49; p = 0.012). Patients with SHPT and high levels of phosphorus, parathyroid hormone, and inflammatory markers were at greater risk for tendon rupture. Surgical complication rates were low. However, results suggest that tendon rupture of knee extensor mechanism in hemodialysis patient with SHPT should be regarded as a “red flag” for future hip fracture.

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