Allogeneic Tendon Transplantation for the Treatment of Pathological Patellar Ligament Defect in Children: Technical Note and 4‐Year Follow‐Up
Abstract Objective The absence of patellar ligament will bring about a severe negative impact on daily life. Many reconstruction techniques have been described in adults. However, there is a lack of technical introduction regarding the reconstruction of the patellar ligament in children. The purpose...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-12-01
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| Series: | Orthopaedic Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/os.13475 |
| _version_ | 1828119158176350208 |
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| author | Min Zhou Yi Long Menglei Yu Jiang Guo Yiyong Tang Fangqi Li Qingyue Li Yuanhao Zhang Zhenze Zheng Jingyi Hou Rui Yang |
| author_facet | Min Zhou Yi Long Menglei Yu Jiang Guo Yiyong Tang Fangqi Li Qingyue Li Yuanhao Zhang Zhenze Zheng Jingyi Hou Rui Yang |
| author_sort | Min Zhou |
| collection | DOAJ |
| description | Abstract Objective The absence of patellar ligament will bring about a severe negative impact on daily life. Many reconstruction techniques have been described in adults. However, there is a lack of technical introduction regarding the reconstruction of the patellar ligament in children. The purpose of this study was to report a surgical technique for reconstructing the patellar ligament in children. Method A retrospective analysis of the clinical data on a patellar ligament (tendon sheath fibroma) patient with allogeneic tendon reconstruction. An 8‐year‐old child with postoperative recurrence of left patellar ligament tumor was enrolled in our study. Anterior tibialis tendon allograft was used to reconstruct the patellar ligament after complete resection of the patellar ligament for the tumor. The tunnels were constructed on the deep surface of the tibial tubercle and the root of the quadriceps tendon (to decrease the harmful impact on patella development), respectively. The allogeneic tendon was passed through the tunnels above in the shape of “8,” and the two ends of the tendon were attached to the bleeding bone bed at the inferior edge of the patella with suture anchors to achieve better bone‐tendon healing. During the follow‐up, the knee's range of motion and imaging manifestations were recorded. Result Postoperative pathology suggests chondromesenchymal hamartoma, a rare benign soft tissue tumor different from the previous operation (tendon sheath fibroma). During the 4‐year follow‐up, the patient's active range of motion of the knee achieved 0° to 120°; and the patient could walk normally without any external help. Physical examinations (the apprehension sign and J sign) showed no ligamentous instability or patellar ligament tenderness. Imaging analysis showed that the ratio length of the patellar ligament to the patella was almost normal. The integrity, continuity, and shape of the allogeneic ligament showed excellent results in MRI. Combined with clinical and imaging findings, allogeneic tendon patellar ligament reconstruction was deemed successful. Conclusion Allogeneic ligament reconstruction technique can provide a treatment option by reconstructing the extensor mechanism, minimizing the impact on patellar development, and augmenting biological healing for children with the absence of the patellar ligament. |
| first_indexed | 2024-04-11T13:43:37Z |
| format | Article |
| id | doaj.art-ffedfa62bf0140628cc38489432783c9 |
| institution | Directory Open Access Journal |
| issn | 1757-7853 1757-7861 |
| language | English |
| last_indexed | 2024-04-11T13:43:37Z |
| publishDate | 2022-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Orthopaedic Surgery |
| spelling | doaj.art-ffedfa62bf0140628cc38489432783c92022-12-22T04:21:10ZengWileyOrthopaedic Surgery1757-78531757-78612022-12-0114123431344010.1111/os.13475Allogeneic Tendon Transplantation for the Treatment of Pathological Patellar Ligament Defect in Children: Technical Note and 4‐Year Follow‐UpMin Zhou0Yi Long1Menglei Yu2Jiang Guo3Yiyong Tang4Fangqi Li5Qingyue Li6Yuanhao Zhang7Zhenze Zheng8Jingyi Hou9Rui Yang10Department of Orthopedics Sun Yat‐sen Memorial Hospital, Sun Yat‐sen University Guangzhou ChinaDepartment of Orthopedics Sun Yat‐sen Memorial Hospital, Sun Yat‐sen University Guangzhou ChinaDepartment of Orthopedics Sun Yat‐sen Memorial Hospital, Sun Yat‐sen University Guangzhou ChinaDepartment of Orthopedics Sun Yat‐sen Memorial Hospital, Sun Yat‐sen University Guangzhou ChinaDepartment of Orthopedics Sun Yat‐sen Memorial Hospital, Sun Yat‐sen University Guangzhou ChinaDepartment of Orthopedics Sun Yat‐sen Memorial Hospital, Sun Yat‐sen University Guangzhou ChinaDepartment of Orthopedics Sun Yat‐sen Memorial Hospital, Sun Yat‐sen University Guangzhou ChinaDepartment of Orthopedics Sun Yat‐sen Memorial Hospital, Sun Yat‐sen University Guangzhou ChinaDepartment of Orthopedics Sun Yat‐sen Memorial Hospital, Sun Yat‐sen University Guangzhou ChinaDepartment of Orthopedics Sun Yat‐sen Memorial Hospital, Sun Yat‐sen University Guangzhou ChinaDepartment of Orthopedics Sun Yat‐sen Memorial Hospital, Sun Yat‐sen University Guangzhou ChinaAbstract Objective The absence of patellar ligament will bring about a severe negative impact on daily life. Many reconstruction techniques have been described in adults. However, there is a lack of technical introduction regarding the reconstruction of the patellar ligament in children. The purpose of this study was to report a surgical technique for reconstructing the patellar ligament in children. Method A retrospective analysis of the clinical data on a patellar ligament (tendon sheath fibroma) patient with allogeneic tendon reconstruction. An 8‐year‐old child with postoperative recurrence of left patellar ligament tumor was enrolled in our study. Anterior tibialis tendon allograft was used to reconstruct the patellar ligament after complete resection of the patellar ligament for the tumor. The tunnels were constructed on the deep surface of the tibial tubercle and the root of the quadriceps tendon (to decrease the harmful impact on patella development), respectively. The allogeneic tendon was passed through the tunnels above in the shape of “8,” and the two ends of the tendon were attached to the bleeding bone bed at the inferior edge of the patella with suture anchors to achieve better bone‐tendon healing. During the follow‐up, the knee's range of motion and imaging manifestations were recorded. Result Postoperative pathology suggests chondromesenchymal hamartoma, a rare benign soft tissue tumor different from the previous operation (tendon sheath fibroma). During the 4‐year follow‐up, the patient's active range of motion of the knee achieved 0° to 120°; and the patient could walk normally without any external help. Physical examinations (the apprehension sign and J sign) showed no ligamentous instability or patellar ligament tenderness. Imaging analysis showed that the ratio length of the patellar ligament to the patella was almost normal. The integrity, continuity, and shape of the allogeneic ligament showed excellent results in MRI. Combined with clinical and imaging findings, allogeneic tendon patellar ligament reconstruction was deemed successful. Conclusion Allogeneic ligament reconstruction technique can provide a treatment option by reconstructing the extensor mechanism, minimizing the impact on patellar development, and augmenting biological healing for children with the absence of the patellar ligament.https://doi.org/10.1111/os.13475allogeneic tendonpatellar ligamentreconstructiontumor |
| spellingShingle | Min Zhou Yi Long Menglei Yu Jiang Guo Yiyong Tang Fangqi Li Qingyue Li Yuanhao Zhang Zhenze Zheng Jingyi Hou Rui Yang Allogeneic Tendon Transplantation for the Treatment of Pathological Patellar Ligament Defect in Children: Technical Note and 4‐Year Follow‐Up Orthopaedic Surgery allogeneic tendon patellar ligament reconstruction tumor |
| title | Allogeneic Tendon Transplantation for the Treatment of Pathological Patellar Ligament Defect in Children: Technical Note and 4‐Year Follow‐Up |
| title_full | Allogeneic Tendon Transplantation for the Treatment of Pathological Patellar Ligament Defect in Children: Technical Note and 4‐Year Follow‐Up |
| title_fullStr | Allogeneic Tendon Transplantation for the Treatment of Pathological Patellar Ligament Defect in Children: Technical Note and 4‐Year Follow‐Up |
| title_full_unstemmed | Allogeneic Tendon Transplantation for the Treatment of Pathological Patellar Ligament Defect in Children: Technical Note and 4‐Year Follow‐Up |
| title_short | Allogeneic Tendon Transplantation for the Treatment of Pathological Patellar Ligament Defect in Children: Technical Note and 4‐Year Follow‐Up |
| title_sort | allogeneic tendon transplantation for the treatment of pathological patellar ligament defect in children technical note and 4 year follow up |
| topic | allogeneic tendon patellar ligament reconstruction tumor |
| url | https://doi.org/10.1111/os.13475 |
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