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DOI: 10.3415/VCOT-07-05-0053
Successful management of bilateral patellar tendon rupture in a dog
Publikationsverlauf
Received
24. Mai 2007
Accepted
23. Juli 2007
Publikationsdatum:
17. Dezember 2017 (online)
![](https://www.thieme-connect.de/media/10.1055-s-00035023/200802/lookinside/thumbnails/10-3415-vcot-07-05-0053-1.jpg)
Summary
A seven-year-old, 41 kg, intact, cross breed dog, was presented with a history of bilateral hind limb lameness after falling from a height of 1 m. Clinical and radiographic findings were consistent with bilateral patellar tendon rupture. Surgical repair was performed bilaterally. The tendons were sutured primarily, and an internal splint of nylon leader was added. Good apposition of the severed tendon ends had been achieved intraoperatively; however, post operative radiographs showed supra-trochlear displacement of both patellae. The casts used to immobilize the stifle joints slipped distally and three days post operatively the tendon repair had broken down, bilaterally. Revision surgery was undertaken and the tendons were re-sutured. Nylon leader was placed through holes that had been drilled in the patellae and tibiae. The stifle joints were immobilized with type I external skeletal fixators (ESFs). Both freeform polymethylmethacrylate (PMMA) connecting bars were found to be broken at the level of the stifle joints two days later, without any disruption of the primary tendon repair. Each connecting bar was replaced with two connecting bars of PMMA reinforced with 3 mm steel wire. The dog was fully weight-bearing with a reduced range of motion in flexion immediately after removal of the ESFs at six weeks and was still sound 18 months post-operatively. Primary tendon repair in combination with adequate immobilization allowed for an excellent outcome in a complicated bilateral pathology.
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References
- 1 Greis PF, Holmstrom MC, Lahav A. Surgical treatment options for patella tendon rupture, Part I: Acute. Orthopedics 2005; 28: 672-679.
- 2 Kellersmann R, Blattert TR, Weckbach A. Bilateral patellar tendon rupture without predisposing systemic disease or steroid use: a case report and review of the literature. Arch Orthop Trauma Surg 2005; 125: 127-133.
- 3 Quintero Quesada J, Mora Villadeamigo J, Abad Rico JI. Spontaneous bilateral patellar tendon rupture in an otherwise healthy patient. A case report. Acta Orthop Belg 2003; 69: 89-92.
- 4 Clark SC, Jones MW, Choudhury RR. et al. Bilateral PT rupture secondary to repeated local steroid injections. J Accid Emerg Med 1995; 4: 300-301.
- 5 Bonamo JJ, Krinick RM, Spron AA. Rupture of the patellar tendon after use of its central third for anterior cruciate reconstruction. A report of two cases. J Bone Joint Surg Am 1984; 66: 1294-1297.
- 6 Jarvela T, Halonen P, Jarvela K. et al. Reconstruction of ruptured patellar tendon after total knee arthroplasty: a case report and description of an alternative fixation method. Knee 2005; 12: 139-143.
- 7 Prasad S, Lee A, Clarnette R. et al. Spontaneous, bilateral patellar tendon rupture in a woman with previous Achilles tendon rupture and systemic lupus erythematosus. Rheumatology (Oxford). 2003; 42: 905-906.
- 8 Provelegios S, Markakis P, Cambouroglou G. et al. Bilateral, spontaneous and simultaneous rupture of the quadriceps tendon in chronic renal failure and secondary hyperparathyroidism. Report of five cases. Arch Anat Cytol Pathol 1991; 39: 228-232.
- 9 Kricun R, Kricun ME, Arangio GA. et al. Patellar tendon rupture with underlying systemic disease. AJR Am J Roentgenol 1980; 135: 803-807.
- 10 Rysavy M, Wozniak A, Arun KP. Spontaneous and simultaneous quadriceps and patella tendon rupture in a patient on chronic hemodialysis. Orthopedics 2005; 28: 603-605.
- 11 Gemmil Gemmil, Carmichael S. Complete patellar tendon replacement using a fascia lata autograft in a dog. J Small Anim Pract 2003; 44: 456-459.
- 12 Bloomberg Bloomberg, Parker RB. Chronic lameness in the dog due to delayed diagnosis of disruption of patellar tendon. J Am Anim Hosp Assoc 1984; 20: 899-904.
- 13 Culvenor JA. Fascia lata graft to reinforce repair of patellar tendon injuries in the dog and cat. J Small Anim Pract 1988; 29: 559-563.
- 14 Aron DN, Selcer BA, Smith JD. Autogenous tensor fascia lata graft replacement of the patellar tendon in a dog. Vet Comp Orthop Traumatol 1997; 10: 141-145.
- 15 Smith MEH, Haan JJ, Peck J. et al. Augmented primary repair of patellar tendon rupture in three dogs. Vet Comp Orthop Traumatol 2000; 13: 154-157.
- 16 Vasseur PB. Stifle joint: Repair of patellar tendon injuries. In: Textbook of Small Animal Surgery 3rd ed. Slatter (ed). Philadelphia: WB. Saunders; 2003: 2128.
- 17 Brinker Brinker. et al. Principles of joint surgery. In: Hand book of Small Animal Orthopaedics and Fracture Repair. Piermattei DL, Flo GL. (eds). Philadelphia: W.B. Saunders; 2006: 223-226.
- 18 Gilmore DR. Patellar ligament rupture in a dog. J Am Vet Med Assoc 1983; 183: 228-229.
- 19 Yamaguchi Yamaguchi, Zajac FE. A planar model of the knee joint to characterize the knee extensor mechanism. J Biomech 1989; 22: 1-10.
- 20 Giblin P, Small A, Nichol R. Bilateral rupture of the ligamentum patellae: two case reports and a review of the literature. Aust N Z J Surg 1982; 52: 145-148.
- 21 Kuo Kuo, Sonnabend DH. Simultaneous rupture of the patellar tendons bilaterally: case report and review of the literature. J Trauma 1993; 34: 458-460.
- 22 Levy Levy, Goldstein J, Rosner M. A method of repair for quadriceps tendon or patellar ligament (tendon) ruptures without cast immobilization. Clin Orthop Rel Res 1987; 218: 297-301.
- 23 Kasten P, Schwe B, Mauerer F. et al. Rupture ofthe patellar tendon: a review of 68 cases and terospective study of 29 ruptures comparing two methods of augmentation. Arch Orthop Trauma Surg 2001; 121: 578-582.
- 24 Marti Marti, Miller A. Delimitation of safe corridors for the insertion of external fixator pins in the dog 1: Hindlimb. J Small Anim Pract 1994; 35: 16-23.