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Document Title: Casey-AJSM-Jul01.shtml
Article Title: Neglected ruptures of the patellar tendon: A case series of four patients
Authors: Michael T. Casey, Jr., MD and Barry R. Tietjens, FRACS
Publication: American Journal of Sports Medicine, Baltimore, Maryland
Date: July-August 2001
Volume 29, Number 4, pages 457-460
(Figures included. Reference-denoting numbers appear in the same point size as the document text.)
Casey et al. describe a series of interesting cases of patellar-tendon failure, and how they repaired the damage by using multiple figure-8 loops of fine wire, thus avoiding the need for tissue-grafting.
ABSTRACT
We describe a series of four patients treated for chronic ruptures of the patellar tendon (more than 6 months old). The proximally retracted patella was brought back to its anatomic position, and the tendon stumps were repaired and protected with multiple strands of strong circlage wire, in a figure-of-8 pattern, from the quadriceps tendon to the tibial tubercle. Postoperatively, immediate mobilization without the use of a brace was initiated. The patients averaged 29 months (range, 8 to 80) from the time of injury until definitive treatment and were observed for an average of 27 months (range, 11 to 40) after treatment. Before treatment, all patients had an extensor lag of at least 20 deg. At initial follow-up, all patients had full active extension with no extensor lag, and this did not deteriorate postoperatively or after wire removal. At the last follow-up, the average flexion was 0 deg to 112 deg. This technique avoids the use of autograft or allograft tissue and does not require lengthening of the quadriceps tendon.
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