Abstract
Introduction: Patients with neglected patellar tendon ruptures present with weakness, instability, extensor lag and sometimes pain. Reports in the literature describe autograft and allograft reconstruction and sometimes quadricepsplasty. Post-operative splintage with a cast or brace is often recommended.
Aim: To describe a simple effective method of surgical treatment for neglected ruptures of the patellar tendon.
Method: Patients who were included all had neglected patellar tendon ruptures that were initially misdiagnosed or had failed other treatment. Through a midline incision scar tissue was excised and two or three strong cerclage wires were used to approximate the patella and ruptured tendon. The wires were passed from the quadriceps tendon to the absorbable sutures in the tibia. No quadricepsplasty was necessary. Following the surgery immediate mobilisation was initiated without the use of a brace. The wires were removed six months following surgery.
Results: Four patients were treated at an average of 29 months following the initial injury. The average follow- up was 26 months (range: 13 to 42 months). The average range of motion was 110 degrees. All patients had improved quadriceps strength, no extensor lag and had returned to work.
Conclusion: We have described a simple effective method of treatment without the use of autograft or allograft. The strong cerclage wires allowed immediate mobilisation.
The abstracts were prepared by Professor Alan Thurston. Correspondence should be addressed to him at the New Zealand Orthopaedic Association, PO Box 7451, Wellington, New Zealand.
