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"Coronal Split/Overlap Repair" Patellar Tendon Shortening in Skeletally Immature Patients
Mohamed Kenawey1,2, Emmanouil Morakis1, Sattar Alshryda3
1Paediatric Orthopaedic Department, Royal Manchester Children's Hospital, Manchester University NHS Foundation Trust, Manchester, United Kingdom.
JBJS Essential Surgical Techniques
|February 26, 2024
Summary
This study describes a patellar tendon shortening technique to treat patella alta in children with cerebral palsy, showing satisfactory correction and improved knee motion with minimal complications.
Area of Science:
- Orthopedic surgery
- Pediatric orthopedics
- Cerebral palsy management
Background:
- Patellar tendon shortening (PTS) addresses patella alta.
- It can be combined with distal femoral extension osteotomy (DFEO) for crouch gait in cerebral palsy.
- This is particularly relevant for skeletally immature patients.
Purpose of the Study:
- To describe a specific coronal split/overlap repair technique for patellar tendon shortening (PTS).
- To detail its application in skeletally immature patients with cerebral palsy.
- To highlight its role in managing patella alta and improving gait.
Main Methods:
- A coronal split of the patellar tendon is performed.
- The tendon is advanced and secured with sutures after distalizing the patella.
- Postoperative management includes a hinged knee brace and restricted quadriceps activity.
Main Results:
- The technique effectively corrects patella alta.
- It can improve total knee range of motion and knee extension during stance.
- Reported complications are primarily superficial infections.
Conclusions:
- The described PTS technique is a viable semi-detaching method.
- It preserves tendon integrity while allowing for early rehabilitation.
- It offers satisfactory outcomes for patella alta and gait issues in pediatric cerebral palsy.
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