Deniz GULABİ, MEHMET ERDEM, GÜVEN BULUT, Fevzi SAĞLAM

Neglected patellar tendon rupture with anterior cruciate ligament rupture and medial collateral ligament partial rupture

Çoğunlukla sportif travmalar sırasında oluşan ön çapraz bağ yaralanmaları sık görülen yaralanmalardır. Bunun aksine, ekstansör mekanizmanın kuvvetli kasılmasına ikincil patellar tendon yırtıkları ise nadir görülürler. Diz etrafında meydana gelen kombine yaralanma olasılıkları göz önünde bulundurulması gereken bir durumdur. Çalışmamızda, ön çapraz bağ yırtığı ve kısmi iç yan bağ yırtığının eşlik ettiği, ihmal edilmiş patellar tendon yırtığı bulunan ve patellar tendon rekonstrüksiyonu ile birlikte uygulanan artroskopik ön çapraz bağ rekonstrüksiyonu ile tedavi edilen bir olgu sunuyoruz.

Ön çapraz bağ yırtığı ve kısmi iç yan bağ yırtığının eşlik ettiği, ihmal edilmiş patellar tendon yırtığı

Anterior cruciate ligament injuries are common, mostly occurring during sports trauma. Conversely, patellar tendon ruptures are uncommon injuries secondary to forceful contractions of the extensor mechanism. It is important to consider the possibility of combined injuries around the knee. We present a case of neglected patellar tendon rupture with anterior cruciate ligament and medial collateral ligament rupture treated with arthroscopic anterior cruciate ligament reconstruction combined with patellar tendon reconstruction.

___

1. Futch LA, Garth WP, Folsom GJ, Ogard WK. Acute rup- ture of the anterior cruciate ligament and patellar tendon in a collegiate athlete. Arthroscopy 2007;23:112.e1-4.
2. Bradley JP, Klimkiewicz JJ, Rytel MJ, Powell JW. Anterior cruciate ligament injuries in the National Football League: epidemiology and current treatment trends among team physicians. Arthroscopy 2002;18:502-9. CrossRef
3. Ong BC, Sherman O. Acute patellar tendon rupture: A new surgical technique. Arthroscopy 2000;16:869-70. CrossRef
4. Enad JG. Patellar tendon ruptures. South Med J 1999;92:563-6. CrossRef
5. Rae PJ, Davies DR. Simultaneous rupture of the ligamen- tum patellae, medial collateral, and anterior cruciate liga- ments. A case report. Am J Sports Med 1991;19:529-30.
6. Levakos Y, Sherman MF, Shelbourne KD, Trakru S, Bonamo JR. Simultaneous rupture of the anterior cruciate ligament and the patellar tendon. Six case reports. Am J Sports Med 1996;24:498-503. CrossRef
7. Costa-Paz M, Muscolo DL, Makino A, Ayerza MA. Si- multaneous acute rupture of the patellar tendon and the anterior cruciate ligament. Arthroscopy 2005;21:1143.
8. Marder RA, Timmerman LA. Primary repair of patellar tendon rupture without augmentation. Am J Sports Med 1999;27:304-7.
9. Wagner LC. Complete rupture of infra-patella tendon and adjacent capsular ligaments. Ann Surg 1927;86:787-9.
10. Insall J, Salvati E. Patella position in the normal knee joint. Radiology 1971;101:101-4.
11. Kelly DW, Carter VS, Jobe FW, Kerlan RK. Patellar and quadriceps tendon ruptures-jumper’s knee. Am J Sports Med 1984;12:375-80. CrossRef
12. Woo SL, Kanamori A, Zeminski J, Yagi M, Papageorgiou C, Fu FH. The effectiveness of reconstruction of the an- terior cruciate ligament with hamstrings and patellar ten- don. A cadaveric study comparing anterior tibial and rota- tional loads. J Bone Joint Surg Am 2002;84-A:907-14.
13. Tsarouhas A, Iosifidis M, Kotzamitelos D, Traios S. Com- bined rupture of the patellar tendon, anterior cruciate liga- ment and lateral. Hippokratia 2011;15:178-80.
14. Hunter RE, Mastrangelo J, Freeman JR, Purnell ML, Jones RH. The impact of surgical timing on postoperative motion and stability following anterior cruciate ligament reconstruction. Arthroscopy 1996;12:667-74. CrossRef
15. Chiang AS, Shin SS, Jazrawi LM, Rose DJ. Simultane- ous ipsilateral ruptures of the anterior cruciate ligament and patellar tendon: a case report. Bull Hosp Jt Dis 2005;62:134-6.
16. Miyamoto RG, Bosco JA, Sherman OH. Treatment of medial collateral ligament injuries. J Am Acad Orthop Surg 2009;17:152-61.
17. Nakamura N, Horibe S, Toritsuka Y, Mitsuoka T, Yo- shikawa H, Shino K. Acute grade III medial collateral ligament injury of the knee associated with anterior cru- ciate ligament tear. The usefulness of magnetic resonance imaging in determining a treatment regimen. Am J Sports Med 2003;31:261-7.
18. Lipscomb AB, Johnston RK, Snyder RB, Warburton MJ, Gilbert PP. Evaluation of hamstring strength follow- ing use of semitendinosus and gracilis tendons to recon- struct the anterior cruciate ligament. Am J Sports Med 1982;10:340-2. CrossRef
19. Yasuda K, Tsujino J, Ohkoshi Y, Tanabe Y, Kaneda K. Graft site morbidity with autogenous semitendinosus and gracilis tendons. Am J Sports Med 1995;23:706-14. CrossRef
20. Eriksson K, Hamberg P, Jansson E, Larsson H, Shalabi A, Wredmark T. Semitendinosus muscle in anterior cruciate ligament surgery: Morphology and function. Arthroscopy 2001;17:808-17. CrossRef
21. Hioki S, Fukubayashi T, Ikeda K, Niitsu M, Ochiai N. Effect of harvesting the hamstrings tendon for ante- rior cruciate ligament reconstruction on the morphol- ogy and movement of the hamstrings muscle: a novel MRI technique. Knee Surg Sports Traumatol Arthrosc 2003;11:223-7. CrossRef