Small Tyler, Reen Michael, Mahoney Kyle, Siebuhr Karl
HCA Florida Ocala Hospital; 1431 SW 1st Ave, Ocala, FL.
Reconstructive Orthopedics of Central Florida; 1500 S Magnolia Ext STE 104, Ocala, FL.
J Orthop Case Rep. 2025 May;15(5):37-42. doi: 10.13107/jocr.2025.v15.i05.5548.
Patellar tendon ruptures are a relatively common injury encountered by orthopedic surgeons and typically only occur unilaterally. However, there are rare reports of bilateral patellar tendon ruptures occurring simultaneously, in patients with underlying systemic disorders, higher energy mechanisms, or injury or overuse in high-level athletes. When patellar tendon ruptures occur, and the extensor mechanism is disrupted, patellar tendon repair versus reconstruction is warranted to restore functionality. The use of dermal allografts for the reconstruction of chronic patellar tendon ruptures is well described; however, there is not much literature describing their use in the acute setting. This report describes the primary repair of simultaneous bilateral patellar tendon rupture with the use of the ArthroFLEX Decellularized Dermal Allograft. This is a novel use for this allograft, as it is currently indicated for use in the treatment of various tendon repairs/reconstructions as well as hallux rigidus and hip capsule reconstruction. There are no reports describing the use of the ArthroFLEX Decellularized Dermal Allograft in the acute setting as augmentation of primary patellar tendon repair in a patient with simultaneous bilateral patellar tendon ruptures in the absence of underlying systemic disease; thus, this report presents a novel use for this dermal allograft.
This patient is a 40-year-old African American male with no active underlying systemic diagnosis who sustained simultaneous bilateral patellar tendon ruptures from a low-energy mechanism. He subsequently underwent bilateral patellar tendon repair during which a dermal allograft augment was utilized to further strengthen this repair. In addition, a defunctioning purse string suture was used to further protect the patellar tendon repair by off loading the extensor mechanism.
This report adds to the body of literature surrounding the rare entity of simultaneous bilateral patellar tendon ruptures in otherwise healthy patients while also presenting a novel use for the ArthroFLEX Decellularized Dermal Allograft in the acute repair of a patellar tendon rupture. This report also supports the use of a defunctioning purse string suture to help offload the healing extensor and decrease the amount of tension across a healing tendon repair.
髌腱断裂是骨科医生相对常见的一种损伤，通常仅单侧发生。然而，有罕见报道称，在患有潜在全身性疾病、更高能量机制损伤或高水平运动员的损伤或过度使用情况下，会同时发生双侧髌腱断裂。当髌腱断裂发生且伸膝机制遭到破坏时，进行髌腱修复或重建以恢复功能是必要的。使用同种异体真皮移植重建慢性髌腱断裂已有详细描述；然而，描述其在急性情况下使用的文献并不多。本报告描述了使用ArthroFLEX脱细胞真皮同种异体移植对同时发生的双侧髌腱断裂进行一期修复。这是该同种异体移植的一种新用途，因为它目前被用于治疗各种肌腱修复/重建以及僵硬性拇趾和髋关节囊重建。尚无报告描述在无潜在全身性疾病的患者同时发生双侧髌腱断裂的急性情况下，使用ArthroFLEX脱细胞真皮同种异体移植增强髌腱一期修复的情况；因此，本报告展示了这种真皮同种异体移植的一种新用途。
该患者是一名40岁的非裔美国男性，无活动性潜在全身性疾病诊断，因低能量机制导致同时双侧髌腱断裂。他随后接受了双侧髌腱修复，术中使用同种异体真皮移植增强以进一步加强修复。此外，还使用了减张荷包缝合线通过减轻伸膝机制负荷来进一步保护髌腱修复。
本报告增加了有关在其他方面健康的患者中同时发生双侧髌腱断裂这一罕见情况的文献资料，同时也展示了ArthroFLEX脱细胞真皮同种异体移植在髌腱断裂急性修复中的新用途。本报告还支持使用减张荷包缝合线来帮助减轻愈合中的伸肌负荷并减少愈合肌腱修复处的张力。
