Double fixation autograft technique for neglected patellar tendon rupture in a low resource setting: A 24 month follow up

Abstract

INTRODUCTION AND IMPORTANCE: Neglected patellar tendon rupture is a rare but disabling condition, often considered as a developing-country entity, due to late diagnosis or inadequate initial management. The therapeutic approach is complex, requiring surgical reconstruction. Several techniques have been described, including the use of autografts, allografts or synthetic materials. CASE PRESENTATION: We report a case of a 45-year-old male with a neglected patellar tendon rupture, treated by reconstruction using semitendinosus and gracilis tendons, fixed through a transosseous tunnel and a Kirschner wire to distribute traction forces on the patella. This technique, economical and suited to limited resources, achieved excellent functional results, while minimizing complications associated with allografts or implants, and avoiding a second operation for material removal. Follow-up at 24 months showed full recovery of active extension, regained stability and quadriceps strength assessed at 5/5. CLINICAL DISCUSSION: Neglected patellar tendon ruptures are rare and challenging, requiring specific surgical techniques such as autografts or allografts to restore knee function. Outcomes depend on surgical techniques and precision, rehabilitation. CONCLUSION: This case highlights the importance of a personalized approach, tailored to the patient's needs and available resources, to ensure optimal recovery.