Department of Orthopedic Surgery, Aichi Hospital, Aichi Cancer Center, Okazaki, Japan.
Ups J Med Sci. 2012 Nov;117(4):460-4. doi: 10.3109/03009734.2012.689379. Epub 2012 Jun 1.
A new reconstruction of the patellar tendon was performed in a 43-year-old patient who lost tendon and tibial tuberosity after a wide tumor resection for low-grade myofibroblastic sarcoma of the parapatellar tendon. In this technique, the patellar tendon was anatomically reconstructed using a fascia lata attached to the iliac bone. The iliac bone was fixed to the tibial bony trough with absorbable screws, and the fascia lata was fashioned into three branches: the central branch was folded through the tunnel in the patella, and the medial and lateral branches were tagged to the medial and lateral retinaculum, respectively, around the patella. The skin defect was covered by the bilateral head of the gastrocnemius flap and a split-thickness skin graft. At the 3-year follow-up, the active range of motion of the knee joint was 0 to 110 degrees. The functional result according to the Musculoskeletal Tumor Society scoring system was 97%. Radiographs showed that the grafted bone was united well to the tibial bone, and the grafted fascia was confirmed as a dark band on MRI. There was no evidence of disease and no complaint of the donor site. This procedure allows for the reconstruction of the patellar tendon in the original location. To our knowledge, this reconstructive procedure of the patellar tendon using the fascia lata attached to the iliac bone has never been reported in English literature.
我们为一位 43 岁的患者实施了一种新的髌腱重建术,该患者因髌腱旁低度恶性肌纤维母细胞肉瘤广泛切除而失去了腱和胫骨粗隆。在这项技术中,我们使用附着在髂骨上的阔筋膜重建髌腱。髂骨用可吸收螺钉固定在胫骨骨槽中,阔筋膜被制成三个分支:中央分支穿过髌骨隧道折叠,内侧和外侧分支分别标记在髌骨周围的内侧和外侧支持带。皮肤缺损由双侧腓肠肌头肌瓣和断层皮片覆盖。在 3 年的随访中,膝关节的主动活动范围为 0 到 110 度。根据肌肉骨骼肿瘤学会评分系统,功能结果为 97%。X 线片显示移植骨与胫骨愈合良好,移植的阔筋膜在 MRI 上呈暗带。无疾病证据,供区无不适。该手术可在原位置重建髌腱。据我们所知,这种使用附着在髂骨上的阔筋膜重建髌腱的方法在英文文献中从未有过报道。