Musallam Baraa, Romano Victor
Department of Surgery and Anesthesia, Midwestern University, 555 31st St, Downers Grove, IL 60515.
Department of Orthopaedic Surgery, Romano Orthopaedic Center, 7411 Lake St, Suite 2110, River Forest, IL 60305.
J Orthop Case Rep. 2022 Dec;12(12):16-20. doi: 10.13107/jocr.2022.v12.i12.3446.
This study highlights the case of a 75-year-old female patient with a history of bilateral knee replacements who presented with a subacute patellar tendon rupture that occurred after falling on her left knee.
The patient had a left total knee replacement one year previously and came in for her one-year follow-up. She presented 3 weeks after her injury with a high-riding patella and a small tibial tubercle avulsion fracture on X-ray, yet she did not experience much pain nor any loss of active extension of her left knee. Despite the severity and subacute presentation of the patient's patellar tendon injury, conservative measures that included physical and occupational therapy was recommended instead of surgery due to her paradoxical retention in gross function of her left knee.
Showcasing this patient's case may provide further understanding of patellar tendon ruptures and tibial avulsion fractures, specifically factors that allow the patient to retain strength and extensor function in her knee to curb the need for surgery.
本研究重点介绍了一名75岁女性患者的病例，该患者有双侧膝关节置换病史，因左膝着地摔倒后出现亚急性髌腱断裂。
该患者一年前进行了左全膝关节置换术，前来进行一年的随访。她在受伤3周后就诊，X线显示髌骨高位及小的胫骨结节撕脱骨折，但她左膝疼痛不明显，主动伸直功能也未丧失。尽管患者髌腱损伤严重且呈亚急性表现，但由于其左膝总体功能存在矛盾性保留，建议采取包括物理治疗和职业治疗在内的保守措施而非手术治疗。
展示该患者的病例可能有助于进一步了解髌腱断裂和胫骨撕脱骨折，特别是那些使患者能够保留膝关节力量和伸肌功能从而避免手术的因素。
