Dataset Information

Frontal Tendon Lengthening Plasty for Treatment of Structural Patella Baja.

ABSTRACT: Patella baja is a severe complication seen after trauma, prolonged immobilization and surgery. Several surgical methods have been described to proximalize the patella without a change in the patella tendon length. Yet, patella tendon shortening and thickening can be regarded as the hallmark pathology. As such, we describe a technique for the lengthening of the patellar tendon to pathoconformly address underlying patella baja. The technique is reproducible and gives the possibility of an early postoperative mobilization to prevent re-baja-a typical complication after patella baja surgery.

SUBMITTER: Bruhin VF

PROVIDER: S-EPMC5263852 | biostudies-literature | 2016 Dec

REPOSITORIES: biostudies-literature

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Publications

Frontal Tendon Lengthening Plasty for Treatment of Structural Patella Baja.

Bruhin Valentino F VF Preiss Stefan S Salzmann Gian M GM Harder Laurent P LP

Arthroscopy techniques 20161205 6

Patella baja is a severe complication seen after trauma, prolonged immobilization and surgery. Several surgical methods have been described to proximalize the patella without a change in the patella tendon length. Yet, patella tendon shortening and thickening can be regarded as the hallmark pathology. As such, we describe a technique for the lengthening of the patellar tendon to pathoconformly address underlying patella baja. The technique is reproducible and gives the possibility of an early po ...[more]

PMID: 28149738

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Project description:Revision patella tendon repairs are technically challenging, and to this point there is no gold standard with regard to treatment. Understanding how the surgeon previously repaired the tendon can be of use in the revision case. This includes a repair using anchor fixation in tunnels from the primary procedure, allograft augmentation under the retinacular layer, and application of a bioinductive implant. Technique Video Video 1 (0-0:05): Title. Video 2. (0:06-0:07): Disclosures. Video 3. (0:08-0:30): Intraoperative setup that includes both legs prepped in. Ensure the operative extremity is on a bone foam, has a tourniquet on, and x-ray machine is in the room. Video 4. (0:31-0:49): It’s critical to evaluate the primary repair. Sutures from the primary repair are seen extending from the inferior pole of the patella into the proximal portion of the tendon. Video 5. (0:50-1:10): This is a critical step in the procedure. Evaluates the patella bone tunnels from the primary repair. This needs to be thoroughly evaluated to determine if they can be used for anchor placement in the revision setting. Video 6. (1:11-1:24): Running locking sutures are placed within in the proximal aspect of the tendon. This suture will be anchored into the inferior pole of the patella using the old bone tunnels. Video 7. (2:12-2:37): Anchors are placed into the inferior pole of the patella using the old bone tunnels. The anchors are loaded using suture that was placed in the tendon. The allograft augmentation path in the retinacular layer is also viewed and showed being tied at the superior pole of the patella. Video 8. (2:38-2:52): Anchors placed within the inferior pole of the patella and the augment path under the retinacular layer. The yellow dotted layer is the path of the augment. Video 9. (1:25-1:40): A guide pin in the tibial tubercle in preparation for the allograft augmentation. This guide pin will be over-reamed. Video 10. (1:41-1:56): The allograft augment is placed through the tunnel and slide proximally. Video 11. (1:57-2:11): The graft is then placed under the retinacular layer. This is passed to the superior pole of the patella. Video 12. (2:53-3:10): Placement of the bioinductive implant over the portion of the tear.

Dataset Information

Frontal Tendon Lengthening Plasty for Treatment of Structural Patella Baja.

Publications

Frontal Tendon Lengthening Plasty for Treatment of Structural Patella Baja.

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