Yamanashi Yuki, Okamoto Takuya, Morishita Yusuke, Takahashi Nobunori, Deie Masataka
Department of Orthopedic Surgery, Aichi Medical University Hospital, Nagakute, JPN.
Department of Rehabilitation Medicine, Aichi Medical University Hospital, Nagakute, JPN.
Cureus. 2025 Jun 20;17(6):e86465. doi: 10.7759/cureus.86465. eCollection 2025 Jun.
Simultaneous rupture of the patellar tendon (PT), anterior cruciate ligament (ACL), and medial collateral ligament is a relatively rare type of trauma. We present a two-stage treatment for this type of trauma. A 47-year-old male who fell from a height of 2 m. The ruptured part of the PT was in poor condition and required strong fixation; therefore, we reconstructed the tendon using quadriceps tendon-patellar bone (QTB) autograft as the first stage of the procedure. After nine months, ACL reconstruction using the semitendinosus tendon (ST) was performed as the second stage. Eighteen months after the first operation, the range of motion (ROM) was 0° of knee extension without any extension lag and 135° of flexion. Radiographs revealed that bone graft incorporation was achieved with an Insall-Salvati ratio of 1.11. The Lachman test and pivot-shift test were negative. There were no postoperative complications, including retear, loss of ROM, or infection. The use of QTB autografts for the rupture of the PT has several advantages. First, the enthesis can be reconstructed with healthy tissue, and the PT length can be maintained. Second, autografts can be expected to be incorporated. Third, the ST can be preserved for ACL reconstruction without invading the contralateral leg.
髌腱（PT）、前交叉韧带（ACL）和内侧副韧带同时断裂是一种相对罕见的创伤类型。我们介绍了针对此类创伤的两阶段治疗方法。一名47岁男性从2米高处坠落。髌腱断裂部分状况不佳，需要强力固定；因此，我们在手术的第一阶段使用股四头肌肌腱-髌骨骨（QTB）自体移植重建肌腱。九个月后，作为第二阶段，使用半腱肌肌腱（ST）进行ACL重建。首次手术后18个月，膝关节活动范围（ROM）为伸直0°，无伸直滞后，屈曲135°。X线片显示骨移植融合良好，Insall-Salvati比率为1.11。Lachman试验和轴移试验均为阴性。没有术后并发症，包括再撕裂、ROM丧失或感染。使用QTB自体移植治疗髌腱断裂有几个优点。首先，可以用健康组织重建止点，并保持髌腱长度。其次，自体移植有望实现融合。第三，可以保留半腱肌肌腱用于ACL重建，而无需侵入对侧腿部。
