title: Reconstruction of chronic patellar tendon rupture with contralateral bone-tendon-bone autograft.
abstract: OBJECTIVE
  To evaluate the clinical and functional outcome following the reconstruction of chronic patellar tendon ruptures using the contralateral bone-tendon-bone (BTB) autograft.
  
  
  METHODS
  The records of seven patients who underwent reconstruction of chronic patellar tendon rupture with contralateral patellar BTB were retrospectively reviewed. Chronic tears were defined as a minimum of 3 months from injury to initial clinical evaluation. Clinical assessments included range of motion of the knee, Tegner, Lysholm and International Knee Documentation Committee (IKDC) score and a radiographic analysis of patellar height (Caton-Deschamps index). Postoperative complications and quadriceps strength at last follow-up were reported.
  
  
  RESULTS
  The mean age of the patients undergoing surgery was 33 (±10.5) years with a mean follow-up of 41.3 (±29.7) months. Reconstruction surgery was performed at an average of 16 months (3-60 months) after the injury. 86 % of the patients had a normal patella height with mean of patellar height of 1.5 (±0.2) in preoperative radiographs and of 1.2 (±0.07) on postoperative evaluation (p = 0.0136). The mean IKDC was 45.5 (±10.8) before surgery and 64.5 (±12.4) at the last follow-up (p = 0.0001), and Lysholm score was 45.4 (±11.3) and 79 (±11.8), respectively (p = 0.0001). The median Tegner activity scale preinjury was 6 (range 5-7), preoperatively was 1 (range 1-2) and 4 (range 2-5) postoperatively (p = 0.0001). All patients had quadriceps wasting with a difference in thigh girth between the injured side and healthy side of 3.6 ± 0.7 cm (ns). No surgical complications were encountered.
  
  
  CONCLUSIONS
  In this limited cohort, surgical reconstruction of chronic patellar tendon ruptures using contralateral bone-tendon-bone graft was a safe and viable option that improves clinical and functional outcomes compared to presurgical function. However, despite the restoration of a normal patellar height, function did not return to preinjury level.
authors.affiliation: Hospital Madre Teresa, Av. Raja Gabáglia 1002, Gutierrez, Belo Horizonte, Minas Gerais, 30430-142, Brazil. dufrois@gmail.com.
authors.forename: Eduardo Frois
authors.identifier: http://orcid.org/0000-0002-3002-9870
authors.initials: EF
authors.lastname: Temponi
authors.affiliation: Centre Orthopedic Santy, FIFA Medical Center of Excelence, Ramsay-Générale de Santé, Hôpital Privé Jean Mermoz, Hôpital Privé Jean Mermoz, Lyon, France.
authors.forename: Nuno
authors.initials: N
authors.lastname: Camelo
authors.affiliation: Centre Orthopedic Santy, FIFA Medical Center of Excelence, Ramsay-Générale de Santé, Hôpital Privé Jean Mermoz, Hôpital Privé Jean Mermoz, Lyon, France.
authors.forename: Sanesh
authors.initials: S
authors.lastname: Tuteja
authors.affiliation: Centre Orthopedic Santy, FIFA Medical Center of Excelence, Ramsay-Générale de Santé, Hôpital Privé Jean Mermoz, Hôpital Privé Jean Mermoz, Lyon, France.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Thaunat
authors.affiliation: Kansas City University, Kansas City, MO, USA.
authors.forename: Matt
authors.initials: M
authors.lastname: Daggett
authors.affiliation: Centre Orthopedic Santy, FIFA Medical Center of Excelence, Ramsay-Générale de Santé, Hôpital Privé Jean Mermoz, Hôpital Privé Jean Mermoz, Lyon, France.
authors.forename: Jean Marie
authors.initials: JM
authors.lastname: Fayard
authors.affiliation: Hospital Madre Teresa, Av. Raja Gabáglia 1002, Gutierrez, Belo Horizonte, Minas Gerais, 30430-142, Brazil.
authors.forename: Lúcio Honório
authors.initials: LH
authors.lastname: de Carvalho Júnior
authors.affiliation: Centre Orthopedic Santy, FIFA Medical Center of Excelence, Ramsay-Générale de Santé, Hôpital Privé Jean Mermoz, Hôpital Privé Jean Mermoz, Lyon, France.
authors.forename: Bertrand
authors.initials: B
authors.lastname: Sonnery-Cottet
mesh_terms: D000328:Adult; D064592:Autografts; D016025:Bone Transplantation / Q000379:methods*; D002908:Chronic Disease; D006801:Humans; D007718:Knee Injuries / Q000601:surgery; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D010329:Patella; D017847:Patellar Ligament / Q000293:injuries / Q000601:surgery* / Q000637:transplantation; D052097:Quadriceps Muscle / Q000503:physiopathology; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures / Q000379:methods*; D020127:Recovery of Function; D012008:Recurrence; D012189:Retrospective Studies; D013708:Tendon Injuries / Q000601:surgery*; D013710:Tendons / Q000637:transplantation; D013848:Thigh; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D055815:Young Adult
keywords: Autograft; Bone-tendon-bone; Chronic injury; Patellar tendon rupture; Reconstruction