Treatment of chronic patellar ligament lesion with autograft and v-y quadricepsplasty

• Main Authors: Marco Túlio Lopes Caldas, Tiago Jacques Gonçalves, Gustavo Henrique Silva Bárbara, Rafael Alves Rodrigues, Victor Rocha Figueiredo, Jaider Parreiras de Paulo
• Format: Article
• Language: English
• Published: Sociedade Brasileira de Ortopedia e Traumatologia 2013-06-01
• Series: Revista Brasileira de Ortopedia
• Subjects: Joelho/terapia; Joelho/cirurgia; Ligamento patelar
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-36162013000300236&lng=en&tlng=en

OBJECTIVE: Review of the literature concerning the subject and to compare the results of the technique we have been using with the ones reported on the literature. METHODS: This is a retrospective, cross-sectional and observational study. We evaluated the records of patients treated surgically at the Hospital from Hospital Maria Amelia Lins January 1997 to January 2011.The following variables were considered: age, gender, side, degree of injury, mechanism of trauma, associated injuries, time elapsed between injury and surgical procedure, complications, range of motion and muscle strength. RESULTS: Five patients underwent surgical treatment with the use of autograft semitendinosus and gracilis tendons and V-Y quadricepsplasty. Regarding gender, there was a male predominance (80%). The average age was 35.2 years old. The right side was the most affected (60%). The predominant mechanism of injury was motorcycle accident (80%). All patients had a complete tendon lesion. Time between injury and surgery averaged 10.4 months. Four patients (80%) had had associated injuries. In all patients muscle strength was satisfactory (M4/M5). Wound dehiscence was observed in 01 patient. Average postoperative range of motion was 110°. CONCLUSIONS: These are rare lesions. Stretching the quadriceps is essential to decrease the tension to the reconstructed patellar ligament and patellofemoral joint. Use of a quadriceps transtendon tunnel is an option to prevent fractures. Hypotrophy of the quadriceps is inevitable, however, the resulting force is sufficient for daily living activities.