Reconstrucción de la rotura crónica del tendon rotular. (Inglés)

Mills, William J MD

Abstract:

Chronic patellar tendon disruption is a disabling injury leaving patients with weakness and instability affecting simple activities of daily living. It is often a sequela of high-energy trauma and usually follows multiple surgical procedures. We have performed Achilles tendon allograft reconstruction of the patellar tendon in 5 patients at Harborview Medical Center. Two patients had neglected rupture treated in a delayed fashion with reconstruction, 2 sustained rerupture of both a primary and secondary repair, and 1 patient with multiple injuries and a patellar tendon disruption formed marked heterotopic ossification of the patellar tendon. All patients had at least a 25-degree extensor lag (range 25-60 degrees), marked patella alta, and were treated with reconstruction of the patellar tendon using cryopreserved Achilles tendon allograft. Quadriceps mobilization and excision of peripatellar adhesions were necessary to regain knee range of motion, and all patients were enrolled in a controlled therapy protocol. No graft failures occurred, and 4 of 5 patients recovered active terminal extension. One patient lacked 3 degrees of terminal extension. The average flexion arc was 123 degrees.