Acta chirurgica Iugoslavica 2013 Volume 60, Issue 2, Pages: 13-21
https://doi.org/10.2298/ACI1302013M
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Disruption of the knee extensor apparatus complicating anterior cruciate ligament reconstruction
Milankov Miroslav (Faculty of Medicine, Clinical Centre of Vojvodina, Department of Orthopaedic Surgery and Traumatology, Novi Sad)
Kecojević Vaso (Faculty of Medicine, Clinical Centre of Vojvodina, Department of Orthopaedic Surgery and Traumatology, Novi Sad)
Rašović Predrag (Faculty of Medicine, Clinical Centre of Vojvodina, Department of Orthopaedic Surgery and Traumatology, Novi Sad)
Kovačević Nemanja (Faculty of Medicine, Clinical Centre of Vojvodina, Department of Orthopaedic Surgery and Traumatology, Novi Sad)
Gvozdenović Nemanja (Faculty of Medicine, Clinical Centre of Vojvodina, Department of Orthopaedic Surgery and Traumatology, Novi Sad)
Obradović Mirko (Faculty of Medicine, Clinical Centre of Vojvodina, Department of Orthopaedic Surgery and Traumatology, Novi Sad)
Disruption of the knee extensor apparatus, after harvesting the central third
of the patellar tendon for a bone-tendon-bone autograft, is a rare
complication. We made 2215 reconstructions of the anterior cruciate ligament
of the knee using bonepatellar tendon-bone technique, and 10 patients had
fracture of the patella (0.45%), and fore patients had rupture of the
patellar tendon(0.18%). The fracture of the patella in two patients was
treated nonoperatively and 8 patients was treated with operative reduction
and osteosynthesis. Reconstruction of the patellar ligament in four patients
with a rupture of patellar tendon (0.18%) was performed by a technique
previously published with BTB allograft taken from the local bone bank. The
mean Lysholm score was 90 (85-100), and all of them have continued to engage
in sporting activities. In all patients the Lachman test was with the firm
stop compared to the other leg. Xray changes in the patella were found in 2
patients, who had multifragmentary fractures of the patella. Disruption of
the knee extensor apparatus, after harvesting the central third of the
patellar tendon for a bone-tendon-bone autograft, can be prevented by
avoiding to take too much bone graft, by using the most precise tools for
cutting, while rehabilitation must be carefully planned. The optimal
treatment disruption of the knee extensor apparatus after the reconstruction
of the anterior cruciate ligament is a operative reconstruction, which allows
continuation of the rehabilitation program.
Keywords: arthroscopy, anterior cruciate ligament reconstruction, complication, patellar fracture, patellar tendon rupture