Multiligamentary knee injury concomitant with patellar tendon rupture – A rare injury pattern

Abstract text (incl. references and figure legends)

Twenty three-year-old man, victim of a motorcycle accident, resulting in trauma of the right knee.He was transferred with the right lower limb immobilized.According to the patient, he had a knee deformity that resolved spontaneously during ambulance transportation. Objectively, he presented joint effusion, medial and anterior laxity, with valgus stress, anterior drawer and Lachman tests positive. Incompetent extensor apparatus. MRI revealed a multiligamentary knee injury concomitant with patellar tendon rupture. One week after the accident, he underwent surgery: intraoperatively, it was found: complete rupture of the patellar tendon, complete rupture of the anterior and posterior cruciate ligaments, rupture of the medial capsule and medial collateral ligament; osteochondral lesion of the medial femoral condyle, with free intraarticular cartilage fragments; menisci without injuries.It was performed the reinsertion of the medial collateral ligament and patellar tendon with anchors and medial joint capsule reconstruction with semitendinosus tendon autograft. An extension splint was applied for 3 weeks, to protect the patellar tendon repair, initiating a protocol of rehabilitation with gradual increase in range of motion. Currently on intensive rehabilitation program, awaiting recovery of the mobility arch to proceed with a new reassessment and eventual second repair time of the cruciate ligaments. Multiligament knee injury associated with concomitant patellar tendon rupture is extremely rare. In 50% of cases this injury is associated with kee dislocation, which spontaneously reduces. The main postoperative concern is to achieve knee stability during the full range of motion, protecting the patellar tendon. Due to its rarity and complexity, with few cases reported in the literature, this lesion is extremely important, and its sharing and discussion is essential.doi.org/10.1016/j.jajs.2018.08.002.doi: 10.3928/01477447-20150105-06.doi: 10.35366/99141.

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