Hamstring Tendon Autograft for Chronic Patellar Tendon Rupture- A Series of Ten Cases

Abstract

Patellar Tendon (PT) rupture is an uncommon injury of the knee extensors. Majority of the PT ruptures occur at the insertion site, on the inferior pole of the patella as an avulsion injury, mostly in males of <40 years of age and involving sports persons or accidental cases. A case series of 10 cases of neglected PT rupture were managed with primary repair along with augmentation with semitendinosus and gracilis (Hamstring tendons) graft. Patient follow-up was done postoperatively at 2nd week, 6th week, 3 months, 6 months, and then yearly. A knee brace was given to the patient postoperatively to immobilise the knee for two weeks. Static quadriceps strengthening exercises were started from postoperative day two. Assisted quadriceps strengthening exercises were allowed after two weeks postoperatively. Active quadriceps strengthening exercises were initiated after four weeks postoperatively. Partial weight bearing was allowed after four weeks and full weight bearing was allowed after eight weeks postoperatively. Postoperatively functional scoring was done using the International Knee Documentation Committee (IKDC) and Lysholm scores, simultaneously checking the knee range of motion, Insaal-Salvati ratio and quadriceps girth. Total of 8 males and 2 females were present with the mean age 43.9 years ranging from 38-53 years. The average period of follow-up was 25.5 months (range 12-39 months). Results were excellent with faster recovery and regain their normal physically active life around 8 months after reconstruction.