A Unique Patellar Tendon Rupture and Small Tibial Avulsion fracture in a Post-Menopausal Patient

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomedical Engineering

Background:

• A 75-year-old female with a history of bilateral knee replacements presented with a subacute patellar tendon rupture.
• The injury occurred after a fall on her left knee, which had undergone a total knee replacement one year prior.

Observation:

• The patient presented three weeks post-injury with a high-riding patella and a small tibial tubercle avulsion fracture on X-ray.
• Despite the injury's severity and subacute presentation, she reported minimal pain and no loss of active knee extension.

Findings:

• Conservative management, including physical and occupational therapy, was recommended over surgery.
• This decision was based on the patient's paradoxical retention of gross motor function in her left knee.

Implications:

• This case offers insights into patellar tendon ruptures and tibial avulsion fractures.
• Understanding factors enabling retained extensor function may help avoid surgical intervention in similar cases.