Modification of the Larson and Simonian technique for reconstruction of chronic patellar tendon rupture.

Abstract

Abstract:

The purpose of this article is to describe a variant of the Larson and Simonian technique for patellar tendon reconstruction.

Introduction: In patellar tendon ruptures, in an acute injury, the plasty is simple and early, if it is chronic, the treatment is modified and for this various techniques have been developed, such as repair with synthetic materials, autografts and allografts.

Clinical case: A 39-year-old male, assessed for high-energy trauma of
1 month’s evolution, with an open fracture of the tibia with a bone defect (3x2cm) above the tibial tuberosity, plus complete rupture of the patellar tendon.

Surgical technique: semitendinosus reconstruction using the modified
Larson and Simonian technique in which we use the remnant of the patellar tendon instead of making bone tunnels in the patella, associating an autologous iliac crest graft for a metaphyseal bone defect.
Results: 3 months postoperatively, 0° extension, 120° flexion and normal
ambulation are evident.

Discussion: Primary reconstruction with early mobilization using allografts, is currently recommended with the advantage of preserving healthy tissues, but with the disadvantage of high cost, delay in integration, compared to
autologous tissue.

Conclusions: Augmentation of the patellar tendon with semitendinosus autograft using remaining useful tissue is a reproducible technique that allows functional and structural restitution of the tendon. With our modification of the Larson and Simonian technique, the risk of fractures and damage to the joint surface is reduced by not making bone tunnels through it.