title: [Transosseous repair of patellar tendon ruptures].
abstract: OBJECTIVE
  Restoration of active knee extension. Restoration of active knee stabilization. Avoiding secondary patella alta.
  
  
  METHODS
  Acute rupture of the patellar tendon within 3-5 days. Chronic rupture of the patellar tendon.
  
  
  METHODS
  Compromised general health status or associated injuries. Compromised local soft-tissue situation.
  
  
  METHODS
  Exposure of the ruptured tendon. Coronal drill hole through the distal third of the patella and coronal drill hole through the tibial tuberosity. After anatomic positioning of the patella (adjusting correct height), patellotibial fixation with monofil or woven (Labitzke) cerclage wire or PDS cord. Suture repair of the patellar tendon and repair of the ruptured medial and lateral retinaculum. Drain insertion. Wound closure in layers.
  
  
  METHODS
  Full load bearing in cylinder cast. Week 0-2: flexion restricted to 30 degrees , quadriceps muscle isometry. Week 2-4: flexion restricted to 60 degrees , strengthening of hip abductors and extensors. Week 4-6: flexion restricted to 90 degrees . After week 6: removal of cylinder cast. After week 12: return to sporting activities, removal of the cerclage wire.
  
  
  RESULTS
  Good results after surgical therapy. Low rate of secondary rupture. Low rate of muscle weakness.
authors.affiliation: Klinik und Poliklinik für Unfallchirurgie, Kliniken der Universität, Langenbeckstrasse 1, Mainz. Dietz@unfall.klinik.uni-mainz.de
authors.forename: Sven-Oliver
authors.initials: SO
authors.lastname: Dietz
authors.forename: Pol Maria
authors.initials: PM
authors.lastname: Rommens
authors.forename: Martin Henri
authors.initials: MH
authors.lastname: Hessmann
mesh_terms: D000208:Acute Disease; D001864:Bone Wires; D002370:Casts, Surgical; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D017847:Patellar Ligament / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D011182:Postoperative Care; D011859:Radiography; D019651:Plastic Surgery Procedures; D012421:Rupture; D013536:Suture Techniques; D052256:Tendinopathy / Q000601:surgery; D013708:Tendon Injuries / Q000175:diagnosis / Q000601:surgery*; D013977:Tibia / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome