[Rupture of the patellar ligament--a late complication after removal of a bone-tendon-bone transplant as cruciate ligament replacement].

Ruptures of the patellar ligament have been observed in surgery for complete substitution of the knee joint and with application of the operation method according to Roux and Goldwilde; ruptures of this ligament after removal of a graft cruciate ligament substitution have been described very rarely. Since 1990 we have been practicing the method of autologous substitution of the cruciate ligament by using material from the median part of the patellar ligament. In one patient treated by this method who had displayed no complications during 10 months after the operation a new adequate trauma resulted in rupture of the patellar ligament at its tibial insertion. As far as we can assess on the basis of available technical literature, such injury might be due to problems of paraligamentary blood supply, partial or complete resection of the infrapatellar fatty tissue additionally contributing to lasting vascular damage.