Patellar tendon ossification after anterior cruciate ligament reconstruction using bone – patellar tendon – bone autograft

BMC Musculoskeletal Disorders

Vittorio Calvisi²  Cosma Calderaro¹  Matteo Ferretti¹  Vincenzo Di Sanzo³  Gianluca Camillieri² 

[1]Orthopaedic Unit, S. Andrea Hospital, “Sapienza” University of Rome, Via di Grottarossa 1035, Rome, 00189, Italy

[2]Piazzale Salvatore Tommasi 1, Blocco 11, L’Aquila, Fraz. Coppito, 67010, Italy

[3]Department of Surgical Sciences, “Sapienza” University of Rome, Viale Regina Elena 324, Rome, 00185, Italy

关键词: Bone-patellar tendon-bone graft;    Anterior cruciate ligament reconstruction;    Ossification;    Patellar tendon;   

Others  :  1132665
DOI  :  10.1186/1471-2474-14-164

 received in 2012-10-28, accepted in 2013-04-18,  发布年份 2013

【 摘 要 】

Background

Among the various complications described in literature, the patellar tendon ossification is an uncommon occurrence in anterior cruciate ligament (ACL) reconstruction using bone – patellar tendon – bone graft (BPTB). The heterotopic ossification is linked to knee traumatism, intramedullary nailing of the tibia and after partial patellectomy, but only two cases of this event linked to ACL surgery have been reported in literature.

Case presentation

We present a case of a 42-year-old Caucasian man affected by symptomatic extended heterotopic ossification of patellar tendon after 20 months from ACL reconstruction using BPTB. The clinical diagnosis was confirmed by Ultrasound, X-Ray and Computed Tomography studies, blood tests were performed to exclude metabolic diseases then the surgical removal of the lesion was performed. After three years from surgery, the patient did not report femoro-patellar pain, there was not range of motion limitation and the clinical-radiological examinations resulted negative.

Conclusion

The surgical removal of the ossifications followed by anti-inflammatory therapy, seems to be useful in order to relieve pain and to prevent relapses. Moreover, a thorough cleaning of the patellar tendon may reveal useful, in order to prevent bone fragments remain inside it and to reduce patellar tendon heterotopic ossification risk.

【 授权许可】

   
2013 Camillieri et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]Valencia H, Gavín C: Infrapatellar heterotopic ossification after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 2003, 15(1):39-42.
• [2]Erdil M, Aşık M, Sen C, Polat G: Heterotopic bone formation following anterior cruciate ligament reconstruction with BPTB autograft. Acta Orthop Traumatol Turc 2012, 46(1):72-76.
• [3]Bruijn JD, Sanders RJ, Jansen BR: Ossification in the patellar tendon and patella alta following sports injuries in children. Complications of sleeve fractures after conservative treatment. Arch Orthop Trauma Surg 1993, 112(3):157-158.
• [4]Matsumoto H, Kawakubo M, Otani T, Fujikawa K: Extensive post-traumatic ossification of the patellar tendon. A report of two cases. J Bone Joint Surg Br 1999, 81(1):34-36.
• [5]Cakici H, Hapa O, Ozturan K, Guven M, Yucel I: Patellar tendon ossification after partial patellectomy: a case report. J Med Case Reports 2010, 4:47. BioMed Central Full Text
• [6]Kelly MA, Insall JN: Postpatellectomy extensive ossification of patellar tendon. A case report. Clin Orthop Relat Res 1987, 215:148-152.
• [7]Gosselin RA, Belzer JP, Contreras DM: Heterotopic ossification of the patellar tendon following intramedullary nailing of the tibia: report on two cases. J Trauma 1993, 34(1):161-163.
• [8]Howell RD, Park JH, Egol KA: Symptomatic heterotopic ossification of the patellar tendon after medial parapatellar intramedullary nailing of the tibia. Orthopedics 2011, 34(3):226.
• [9]Tornetta P 3rd, Barbera C: Severe heterotopic bone formation in the knee after tibial intramedullary nailing. J Orthop Trauma 1992, 6(1):113-115.
• [10]Chen A, Chmell S: Heterotopic ossification after patellar tendon repair in a man with trisomy 8 mosaicism: a case report and literature review. J Med Case Reports 2011, 5:453. BioMed Central Full Text
• [11]Erdogan F, Aydingoz O, Kesmezacar H, Erginer R: Calcification of the patellar tendon after ACL reconstruction. A case report with long-term follow-up. Knee Surg Sports Traumatol Arthrosc 2004, 12(4):277-279.