J Knee Surg 2013; 26(S 01): S123-S127
DOI: 10.1055/s-0032-1324810
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Nonoperative Management of a Partial Patellar Tendon Rupture after Bone-Patellar Tendon-Bone Graft Harvest for ACL Reconstruction

Rodney W. Benner
1   Department of Orthopaedic Surgery, UT-Memphis/Campbell Clinic, Memphis, Tennessee
,
K. Donald Shelbourne
2   Shelbourne Knee Center, Indianapolis, Indiana
,
Heather Freeman
2   Shelbourne Knee Center, Indianapolis, Indiana
› Author Affiliations
Further Information

Publication History

18 April 2012

28 June 2012

Publication Date:
21 September 2012 (online)

Abstract

This is a case report of a young athlete who sustained a partial tear of the patellar tendon after anterior cruciate ligament (ACL) reconstruction with a bone-patellar tendon-bone (BPTB) autograft. The injury, diagnostic workup, and decision-making process that lead to the choice of nonsurgical treatment are described. Furthermore, the rehabilitation process is described in detail. The patient returned to his previous level of sports activity and had a good clinical outcome as measured by range of motion, isokinetic quadriceps muscle strength testing, single leg hop testing, and the modified Noyes survey. In the absence of extensor mechanism incompetence or radiographic evidence of significant patella alta, partial ruptures of the patella tendon after ACL reconstruction using a BPTB autograft may be treated nonoperatively.

 
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