title: Repair and augmentation of a spontaneous patellar tendon rupture in a patient with Ehlers-Danlos syndrome: a case report.
abstract: BACKGROUND
  Disruption of the knee extensor mechanism is a serious disorder that requires prompt treatment. It often occurs in the form of a patellar tendon rupture. It may occur in association with systemic disease or after administration of corticosteroids or fluoroquinolones. These conditions can cause tendon weakness, and consequent ruptures usually require both repair and augmentation. This paper reports on repair and augmentation for treating patellar tendon rupture in patients with Ehlers-Danlos syndrome (EDS).
  
  
  METHODS
  We report a patellar tendon rupture in a 27-year-old man with EDS, which occurred in the midsubstance of the patella. As the patient has tendon weakness, extensive repair will increase the risk of patella baja, and the use of end-to-end suturing technique alone will not be enough to prevent a rupture recurring; however, augmentation could be used to address the tendon weakness. Repair of the rupture and augmentation with hamstring tendon was performed. One year after the surgery, the patient was able to move his knee joint without pain and had an active range of motion of 0° (passive 20°)-145°. He was able to perform a straight leg raise without an extension lag.
  
  
  CONCLUSIONS
  Repair and augmentation with hamstring tendon was an effective treatment option for patellar tendon rupture in a patient with EDS.
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medical Science, Kanazawa University, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan, y.takata.14@gmail.com.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Takata
authors.forename: Junsuke
authors.initials: J
authors.lastname: Nakase
authors.forename: Hitoaki
authors.initials: H
authors.lastname: Numata
authors.forename: Takeshi
authors.initials: T
authors.lastname: Oshima
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tsuchiya
mesh_terms: D000328:Adult; D004535:Ehlers-Danlos Syndrome / Q000150:complications*; D006801:Humans; D007719:Knee Joint / Q000502:physiology / Q000601:surgery; D007866:Leg; D008297:Male; D019637:Orthopedic Procedures / Q000379:methods*; D017847:Patellar Ligament / Q000293:injuries* / Q000601:surgery*; D016059:Range of Motion, Articular / Q000502:physiology; D012421:Rupture / Q000601:surgery; D013536:Suture Techniques; D013708:Tendon Injuries / Q000601:surgery*; D013710:Tendons / Q000601:surgery / Q000637:transplantation; D016896:Treatment Outcome