• Nicola Maffulli, Angelo Del Buono, Mattia Loppini, and Vincenzo Denaro.
• Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and Dentistry, Mile End Hospital, 275 Bancroft Road, London E1 4DG, England.
• J Bone Joint Surg Am. 2013 Sep 4; 95 (17): e1231-6.

BackgroundPatellar tendon reconstruction is technically demanding and is indicated in patients with chronic ruptures (i.e., still present more than six weeks after injury). The purpose of this study was to assess the effectiveness of this procedure in patients with impaired function following patellar tendon rupture.MethodsNineteen patients underwent autologous ipsilateral hamstring tendon graft reconstruction for management of a chronic patellar tendon rupture. The clinical diagnosis was supported by imaging radiographs and magnetic resonance imaging. The modified Cincinnati rating system questionnaire and the Kujala scoring questionnaire were administered preoperatively and at the last examination, an average follow-up of 5.8 years (range, four to 7.8 years) postoperatively. Thigh volume, cross-sectional area of the thigh (muscle and bone), and the maximum isometric voluntary contraction strength of the extensor apparatus of the knee were measured bilaterally in all nineteen patients.ResultsAt the last follow-up visit, knee flexion had increased from a mean of 110° preoperatively to a mean of 132° and extension lag had significantly decreased from 20° preoperatively to 3°; the mean modified Cincinnati and Kujala scores were notably improved. All patients had returned to ordinary daily activities. Fourteen of nineteen patients were very satisfied with the procedure, three were satisfied, one was moderately satisfied, and one was unsatisfied.ConclusionsOn the basis of our review of nineteen patients, hamstring tendon reconstruction of chronic patellar tendon rupture provided good functional recovery and return to preinjury daily activities.

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