Patella fracture during rehabilitation after bone-patellar tendon-bone anterior cruciate ligament reconstruction: 2 case reports.
METHODS
Case report.


BACKGROUND
Patellar fracture is a rare but significant complication following anterior cruciate ligament (ACL) reconstruction when using a bone-patellar tendon-bone (BPTB) autograft. The purpose of these case reports is to describe 2 cases in which patellar fracture occurred during rehabilitation after ACL reconstruction using a BPTB.


METHODS
Both patients were 23-year-old males referred for rehabilitation after ACL reconstruction using a BPTB autograft. They were both progressing satisfactorily in rehabilitation until sustaining a fracture of the patella. One fracture occurred during the performance of the eccentric phase of a knee extension exercise during the sixth week of rehabilitation (7 weeks postsurgery), whereas the other fracture occurred during testing of the patient is quadriceps maximum voluntary isometric contraction in the ninth week of rehabilitation (10 weeks postsurgery). Both patients were subsequently treated with open reduction and internal fixation of the patella.


CONCLUSIONS
During rehabilitation following ACL reconstruction using BPTB autograft, clinicians should consider the need to balance the sometimes-competing goals of improving quadriceps strength while providing protection to the healing graft, minimization of patellofemoral pain, and protection of the patellar donor site.
University of Pittsburgh, Pittsburgh, PA 15260, USA. spiva@pitt.edu
Sara R
SR
Piva
John D
JD
Childs
Brian M
BM
Klucinec
James J
JJ
Irrgang
Gustavo J M
GJ
Almeida
G Kelley
GK
Fitzgerald
D016118:Anterior Cruciate Ligament / Q000601:surgery*; D003937:Diagnosis, Differential; D005081:Exercise Therapy / Q000009:adverse effects*; D050723:Fractures, Bone / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D007718:Knee Injuries / Q000601:surgery*; D008297:Male; D010329:Patella / Q000294:innervation*; D019651:Plastic Surgery Procedures / Q000379:methods*; D055815:Young Adult