[Transosseous repair of patellar tendon ruptures].
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.
Dietz
Sven-Oliver
SO
Klinik und Poliklinik für Unfallchirurgie, Kliniken der Universität, Langenbeckstrasse 1, Mainz. Dietz@unfall.klinik.uni-mainz.de
Rommens
Pol Maria
PM
Hessmann
Martin Henri
MH
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