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Surgical repair of chronic patellar tendon rupture in total knee replacement with ipsilateral hamstring tendons

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Patellar tendon rupture is a serious complication of total knee arthroplasty (TKA). Its reconstruction in patients with chronic ruptures is technically demanding. This article reports the results of surgical reconstruction of neglected patellar tendon rupture in TKA using autologous hamstring tendons.

Methods

Nine TKA patients (six women and three men) (mean age at index surgery 68 years) with chronic patellar tendon tears underwent reconstruction with ipsilateral hamstrings tendon, leaving the distal insertion in situ. The clinical diagnosis was supported by imaging (anterior–posterior and 30° flexion lateral radiographs). Insall–Salvati index, range of motion, and leg extension test were recorded preoperatively and at last follow-up. The modified Cincinnati rating system and the Kujala score were administered. The patients sustained the patellar tendon tear an average of 8 weeks before the procedure.

Results

At final follow-up of 4 years (range 2–8 years), the median of extension lag was 5° (range 0°–15°; DS = 5). The median of post-operative Insall–Salvati index was 1.4 (range 1.3–1.8; SD = 0.15; p = 0.002) compared to the preoperative index of 1.7 (range 1.5–2.2; SD = 0.23). The mean modified Cincinnati and Kujala scores significantly increased compared with the preoperative ones (p < 0.01). At final follow-up, all patients were able to walk without brace or aids, and they were satisfied with the procedure.

Conclusion

Based on our retrospective study of nine patients, reconstruction of neglected patellar tendon rupture in TKA with autologous hamstring tendons is feasible and safe, and provides good functional recovery.

Level of evidence

Case series, Level IV.

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Acknowledgments

None of the authors received payments or services, either directly or indirectly (that is via his or her institution), from a third party in support of any aspect of this work. None of the authors, or their institution(s), have had any financial relationship, in the 36 months prior to submission of this work, with any entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. Also, no author has had any other relationships or has engaged in any other activities that could be perceived to influence or have the potential to influence what is written in this work.

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Authors and Affiliations

  1. Department of Orthopaedics and Traumatology, San Camillo-Forlanini Hospital, Piazza C. Forlanini 1, Rome, Italy

    Marco Spoliti

  2. Department of Orthopaedic and Traumatology, University of Rome “Tor Vergata”, School of Medicine, Viale Oxford 81, 00133, Rome, Italy

    Alessio Giai Via & Francesco Oliva

  3. University e-Campus, Novedrate, Italy

    Johnny Padulo

  4. Tunisian Research Laboratory ‘Sports Performance Optimization’, National Center of Medicine and Science in Sport, Tunis, Tunisia

    Johnny Padulo

  5. Department of Orthopaedic and Trauma Surgery, Hospital Antonio Cardarelli, Contrada Tappino, Campobasso, Italy

    Angelo Del Buono

  6. Department of Musculoskeletal Disorders, School of Medicine and Surgery, University of Salerno, Salerno, Italy

    Nicola Maffulli

  7. Queen Mary University of London, Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Mile End Hospital, 275 Bancroft Road, London, E1 4DG, UK

    Nicola Maffulli

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  1. Marco Spoliti
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  2. Alessio Giai Via
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Correspondence to Nicola Maffulli.

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Spoliti, M., Giai Via, A., Padulo, J. et al. Surgical repair of chronic patellar tendon rupture in total knee replacement with ipsilateral hamstring tendons. Knee Surg Sports Traumatol Arthrosc 24, 3183–3190 (2016). https://doi.org/10.1007/s00167-014-3448-9

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  • DOI: https://doi.org/10.1007/s00167-014-3448-9

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