• Eduardo Frois Temponi, Nuno Camelo, Sanesh Tuteja, Mathieu Thaunat, Matt Daggett, Jean Marie Fayard, de Carvalho Júnior Lúcio Honório LH Hospital Madre Teresa, Av. Raja Gabáglia 1002, Gutierrez, Belo Horizonte, Minas Gerais, 30430-142, Brazil., and Bertrand Sonnery-Cottet.
• Hospital Madre Teresa, Av. Raja Gabáglia 1002, Gutierrez, Belo Horizonte, Minas Gerais, 30430-142, Brazil. dufrois@gmail.com.
• Knee Surg Sports Traumatol Arthrosc. 2017 Aug 1; 25 (8): 2468-2473.

PurposeTo evaluate the clinical and functional outcome following the reconstruction of chronic patellar tendon ruptures using the contralateral bone-tendon-bone (BTB) autograft.MethodsThe records of seven patients who underwent reconstruction of chronic patellar tendon rupture with contralateral patellar BTB were retrospectively reviewed. Chronic tears were defined as a minimum of 3 months from injury to initial clinical evaluation. Clinical assessments included range of motion of the knee, Tegner, Lysholm and International Knee Documentation Committee (IKDC) score and a radiographic analysis of patellar height (Caton-Deschamps index). Postoperative complications and quadriceps strength at last follow-up were reported.ResultsThe mean age of the patients undergoing surgery was 33 (±10.5) years with a mean follow-up of 41.3 (±29.7) months. Reconstruction surgery was performed at an average of 16 months (3-60 months) after the injury. 86 % of the patients had a normal patella height with mean of patellar height of 1.5 (±0.2) in preoperative radiographs and of 1.2 (±0.07) on postoperative evaluation (p = 0.0136). The mean IKDC was 45.5 (±10.8) before surgery and 64.5 (±12.4) at the last follow-up (p = 0.0001), and Lysholm score was 45.4 (±11.3) and 79 (±11.8), respectively (p = 0.0001). The median Tegner activity scale preinjury was 6 (range 5-7), preoperatively was 1 (range 1-2) and 4 (range 2-5) postoperatively (p = 0.0001). All patients had quadriceps wasting with a difference in thigh girth between the injured side and healthy side of 3.6 ± 0.7 cm (ns). No surgical complications were encountered.ConclusionsIn this limited cohort, surgical reconstruction of chronic patellar tendon ruptures using contralateral bone-tendon-bone graft was a safe and viable option that improves clinical and functional outcomes compared to presurgical function. However, despite the restoration of a normal patellar height, function did not return to preinjury level.

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