BACKGROUNDPatellar tendon and anterior cruciate ligament (ACL) tear is an uncommon injury. Moreover, the mechanism of injury and the best surgical approach have not been established yet. We believe that case reports like ours contribute to a better understanding of the mechanism of injury and help the surgeon to decide whether to proceed in one-or twostage procedure.
CASE PRESENTATIONA 47-year-old professional driver presented in the outpatient clinic of our department after sustaining an injury in his left knee. He was manually unloading a heavy package from his truck and while descending to the ground he felt a double 'pop' in his left knee and fell down. Physical examination revealed diffuse knee swelling. The knee was extremely tender, even in slight palpation, especially anteriorly and medially. A palpable defect of the patella tendon was detected, and active knee extension was impossible. Valgus stress demonstrated medial collateral ligament (MCL) disruption while Lachman-Noulis and pivot-shift test could not be performed because of the intense pain. The anteroposterior and lateral radiographs showed superior displacement of the patella without any other osseous pathology. Consequently, the patient was admitted in our department, under the diagnosis of patellar tendon and MCL tear.