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Ipsilateral hamstring tendon graft reconstruction for chronic patellar tendon ruptures: surgical technique
Nicola Maffulli1, Angelo Del Buono2, Francesco Oliva3
1Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, Salerno, Italy; Centre for Sports and Exercise Medicine, Mile End Hospital, Barts and The London School of Medicine and Dentistry, London, UK.
Background:
Patellar tendon chronic ruptures are more debated to manage that acute injuries as the patella tends to retract proximally (after 2 weeks), and surrounding soft tissues may make the repair more complicate.
Purpose:
We propose a novel technique in which the patellar tendon is reconstructed using ipsilateral hamstring tendons. This surgical procedure implies to drill a single tunnel through the patella and another through the tibia to reduce the risk of bony breakage. In addition, the tendon is secured to the bone, at the tunnel exit points, by periostium sutures without requiring any additional surgery for hardware removal.
Methods:
We assessed 19 patients (16 men and 3 women) who underwent PT reconstruction at an average of 5.8 years (range, 4 to 7.8 years, SD: 3.5) from the index surgery. The mean age at surgery was 46 ± 9.2 years (range, 38-59 years).
Results:
All patients had a complete tear of the patellar tendon.
Conclusions:
The main indication for this procedure is the reconstruction of the PT in patients with chronic rupture (>6 weeks) in which the tendon gap is greater than 2 centimeters and the scar tissues and degenerated tendon ends do not allow to juxtapose the tendon stumps to each other.
Level Of Evidence:
Level IV.
