Treatment of a Neglected Patellar Tendon Rupture with a Modified Surgical Technique: Ipsilateral Semitendinosus Autograft Reconstruction with Suture Tape Augmentation

Figure 3

(a) The semitendinosus autograft is passed through the bone tunnel from medial to lateral and courses along the lateral aspect of the native patellar tendon. Small rents are created in the medial and lateral retinacula at the level of the superior pole of the patella, and the graft is woven transversely through the distal quadriceps tendon from lateral to medial. The graft is then brought down along the medial border of the native patellar tendon and passed through the bone tunnel from lateral to medial. The free ends cross in opposite directions within the tibial bone tunnel and are secured within the tibial tunnel using two interference screws (Tenodesis Screw, BioComposite, 6.25 × 15 mm; Arthrex, Naples, FL)—one from medial to lateral and one from lateral to medial. (b) An InternalBrace (Arthrex, Naples, FL) is used to augment and protect the reconstruction. Two 4.75 × 15 mm SwiveLock BioComposite suture anchors (Arthrex, Naples, FL) are placed into the distal pole of the patella securing the midpoint of one 2 mm FiberTape suture tape (Arthrex, Naples, FL) each. The free limbs of the FiberTape (Arthrex, Naples, FL) cross the repair site—one limb straight inferior and the other in an “X” fashion—and are then secured to the tibial tubercle using two 4.75 × 15 mm SwiveLock BioComposite suture anchors (Arthrex, Naples, FL).

(a)

(b)