Takata Yasushi, Nakase Junsuke, Numata Hitoaki, Oshima Takeshi, Tsuchiya Hiroyuki
Department of Orthopaedic Surgery, Graduate School of Medical Science, Kanazawa University, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan,
Arch Orthop Trauma Surg. 2015 May;135(5):639-44. doi: 10.1007/s00402-015-2179-9. Epub 2015 Feb 22.
Disruption of the knee extensor mechanism is a serious disorder that requires prompt treatment. It often occurs in the form of a patellar tendon rupture. It may occur in association with systemic disease or after administration of corticosteroids or fluoroquinolones. These conditions can cause tendon weakness, and consequent ruptures usually require both repair and augmentation. This paper reports on repair and augmentation for treating patellar tendon rupture in patients with Ehlers-Danlos syndrome (EDS).
We report a patellar tendon rupture in a 27-year-old man with EDS, which occurred in the midsubstance of the patella. As the patient has tendon weakness, extensive repair will increase the risk of patella baja, and the use of end-to-end suturing technique alone will not be enough to prevent a rupture recurring; however, augmentation could be used to address the tendon weakness. Repair of the rupture and augmentation with hamstring tendon was performed. One year after the surgery, the patient was able to move his knee joint without pain and had an active range of motion of 0° (passive 20°)-145°. He was able to perform a straight leg raise without an extension lag.
Repair and augmentation with hamstring tendon was an effective treatment option for patellar tendon rupture in a patient with EDS.
膝关节伸肌机制断裂是一种需要及时治疗的严重病症。它常以髌腱断裂的形式出现。可能与全身性疾病相关，或在使用皮质类固醇或氟喹诺酮类药物后发生。这些情况会导致肌腱无力，因此随之而来的断裂通常需要修复和加强。本文报道了对患有埃勒斯-当洛综合征（EDS）的患者进行髌腱断裂修复及加强的情况。
我们报告了一名27岁患有EDS的男性髌腱断裂病例，断裂发生在髌骨中部。由于该患者存在肌腱无力的情况，广泛修复会增加髌骨低位的风险，仅使用端端缝合技术不足以防止再次断裂；然而，加强措施可用于解决肌腱无力问题。我们对断裂进行了修复，并使用腘绳肌腱进行了加强。术后一年，患者能够无痛地活动膝关节，主动活动范围为0°（被动20°）至145°。他能够进行直腿抬高且无伸膝滞后。
对于患有EDS的患者，使用腘绳肌腱进行修复和加强是治疗髌腱断裂的一种有效治疗选择。
