Mungalpara Nirav, Sreedharareddy Ravikumar, Gourineni Prasad, Kolanu Nikhil Deep, Ringim Abdullahi Habib
Department of Orthopaedic Surgery, Amara Hospital, Karakambadi, AP 517 520 India.
University of Illinois, Chicago, IL USA.
Indian J Orthop. 2023 Aug 7;57(9):1387-1400. doi: 10.1007/s43465-023-00962-y. eCollection 2023 Sep.
To review reliable techniques for reconstructing or repairing chronic patella tendon tears and describe the unique case report of chronic patellar tendon tear with heterotopic ossification (HO).
A 47-year-old male presented with chronic patellar tendon tears with HO, resulting in an inability to extend the right knee fully. Krackow suture repair augmented by autograft semitendinosus and gracilis was employed after debriding intra-substance patella tendon HO and fibrotic tissue. The repair was augmented using a method described by Chen et al. Postoperative recovery was uneventful, and the patient demonstrated an excellent Knee Society Score (86/100) at 6 months of follow-up. Proximal migration of the patella, poor tissue quality, scar tissue formation, and quadriceps atrophy pose unique challenges in managing chronic patellar tendon tears.
HO increased the probability of patella baja after the reconstruction. To alleviate that, precise pre-op planning, careful method selection, and proper execution of the selected method are very important. A comprehensive review of 14 different methodologies for managing chronic patellar tendon tears, comprising eight case series and six case reports, was conducted. The selection of an appropriate technique should be based on individual patient characteristics, resource availability, and the surgeon's expertise.
回顾重建或修复慢性髌腱撕裂的可靠技术，并描述慢性髌腱撕裂伴异位骨化（HO）的独特病例报告。
一名47岁男性因慢性髌腱撕裂伴HO就诊，导致右膝无法完全伸直。在清除髌腱实质内的HO和纤维化组织后，采用Krackow缝合法修复，并取自体半腱肌和股薄肌进行加强。修复采用了Chen等人描述的方法。术后恢复顺利，患者在随访6个月时膝关节协会评分极佳（86/100）。髌骨近端移位、组织质量差、瘢痕组织形成和股四头肌萎缩在慢性髌腱撕裂的处理中带来了独特的挑战。
HO增加了重建后髌骨低位的可能性。为缓解这一情况，精确的术前规划、谨慎的方法选择以及所选方法的正确实施非常重要。对14种不同的慢性髌腱撕裂处理方法进行了全面回顾，包括8个病例系列和6个病例报告。应根据患者个体特征、资源可用性和外科医生的专业知识选择合适的技术。
