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Neglected Ruptures of the Patellar Tendon

A Case Series of Four Patients

Michael T. Casey, Jr, MD and Barry R. Tietjens, FRACS

Unisports Sports Medicine Clinic, Eastwood Orthopaedic Clinic, Auckland, New Zealand

Presented at The World Congress on Orthopedic Sports Trauma, Queensland, Australia, April 2000.

Address correspondence and reprint requests to Michael T. Casey, Jr., MD, Hovis Orthopedic Clinic, 501 19th Street, 702 Trustees Tower, Knoxville, TN 37916

We describe a series of four patients treated for chronic ruptures of the patellar tendon (more than 6 months old). The proximally retracted patella was brought back to its anatomic position, and the tendon stumps were repaired and protected with multiple strands of strong circlage wire, in a figure-of-8 pattern, from the quadriceps tendon to the tibial tubercle. Postoperatively, immediate mobilization without the use of a brace was initiated. The patients averaged 29 months (range, 8 to 80) from the time of injury until definitive treatment and were observed for an average of 27 months (range, 11 to 40) after treatment. Before treatment, all patients had an extensor lag of at least 20°. At initial follow-up, all patients had full active extension with no extensor lag, and this did not deteriorate postoperatively or after wire removal. At the last follow-up, the average flexion was 0° to 112°. This technique avoids the use of autograft or allograft tissue and does not require lengthening of the quadriceps tendon.