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Extensor Mechanism Reconstruction for Chronic Patellar Tendon Tears.

Addison Cimino1, Kevin C Wall1, Joseph Elphingstone1

  • 1From the Department of Orthopaedics, University of Alabama at Birmingham, Birmingham.

Southern Medical Journal
|February 1, 2023
PubMed
Summary

Patellar tendon reconstruction for chronic tears in native knees shows satisfactory outcomes. This systematic review found significant improvements in range of motion and function, with no major complications reported.

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Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Biomaterials Science

Background:

  • Chronic patellar tendon rupture is an uncommon injury leading to significant functional limitations.
  • Existing literature consists of case series, lacking a synthesized overview of outcomes and techniques.
  • This review addresses the need for a systematic evaluation of patellar tendon reconstruction in native knees.

Approach:

  • A systematic review was conducted following PRISMA guidelines.
  • Searches included MEDLINE (PubMed), Cochrane Database, and clinicaltrials.gov.
  • Studies reporting outcomes and techniques for chronic patellar tendon reconstruction in native knees were identified and analyzed.

Key Points:

  • Ten studies involving 105 knees were included, excluding arthroplasty cases.
  • Hamstring tendon grafts were most common (75%), followed by bone-tendon-bone (13%) and allografts (7%).
  • Significant improvements observed: mean Lysholm score increased from 58.6 to 86.0; range of motion improved from 113.8° to 126.0°.
  • 100% returned to work, 76% to prior physical activity levels.
  • No major complications were reported across the included studies.

Conclusions:

  • Patellar tendon reconstruction for chronic tears in native knees yields satisfactory outcomes with current surgical techniques.
  • While graft choice requires further elucidation, the procedure effectively restores function and activity levels.
  • This systematic review provides valuable insights into the efficacy and safety of this uncommon surgical procedure.