title: Patellar tendon ossification after anterior cruciate ligament reconstruction using bone--patellar tendon--bone autograft.
abstract: BACKGROUND
  Among the various complications described in literature, the patellar tendon ossification is an uncommon occurrence in anterior cruciate ligament (ACL) reconstruction using bone - patellar tendon - bone graft (BPTB). The heterotopic ossification is linked to knee traumatism, intramedullary nailing of the tibia and after partial patellectomy, but only two cases of this event linked to ACL surgery have been reported in literature.
  
  
  METHODS
  We present a case of a 42-year-old Caucasian man affected by symptomatic extended heterotopic ossification of patellar tendon after 20 months from ACL reconstruction using BPTB. The clinical diagnosis was confirmed by Ultrasound, X-Ray and Computed Tomography studies, blood tests were performed to exclude metabolic diseases then the surgical removal of the lesion was performed. After three years from surgery, the patient did not report femoro-patellar pain, there was not range of motion limitation and the clinical-radiological examinations resulted negative.
  
  
  CONCLUSIONS
  The surgical removal of the ossifications followed by anti-inflammatory therapy, seems to be useful in order to relieve pain and to prevent relapses. Moreover, a thorough cleaning of the patellar tendon may reveal useful, in order to prevent bone fragments remain inside it and to reduce patellar tendon heterotopic ossification risk.
authors.affiliation: Department of Orthopaedic Surgery, University of L’Aquila, Rome, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Camillieri
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Di Sanzo
authors.forename: Matteo
authors.initials: M
authors.lastname: Ferretti
authors.forename: Cosma
authors.initials: C
authors.lastname: Calderaro
authors.forename: Vittorio
authors.initials: V
authors.lastname: Calvisi
mesh_terms: D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction / Q000009:adverse effects / Q000379:methods*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D050376:Bone-Patellar Tendon-Bone Grafting / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007718:Knee Injuries / Q000601:surgery*; D008297:Male; D009999:Ossification, Heterotopic / Q000209:etiology / Q000473:pathology* / Q000628:therapy; D017847:Patellar Ligament / Q000473:pathology / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology / Q000473:pathology* / Q000628:therapy; D016059:Range of Motion, Articular
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal