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heterotopic ossification of patellar tendon

William T Kent, Trevor J Shelton, Jonathan Eastman
PURPOSE: Floating knee injuries are relatively uncommon injuries. We report the prevalence, location, and severity of heterotopic ossification (HO) around the knee in patients treated with antegrade tibial intramedullary nailing and ipsilateral antegrade versus retrograde femoral intramedullary nailing as well as how the severity of HO around the knee affects knee range of motion (ROM). METHODS: From 2004 to 2014, 26 floating knee injuries were included. Radiographs were reviewed to determine presence, location, and severity of HO...
February 22, 2018: International Orthopaedics
Norio Yamamoto, Takaaki Miki, Akihiro Nishiyama, Tomoyuki Dan'ura, Yuzuru Matsui, Toshifumi Ozaki
This is the first report of extensive bilateral patellar tendon ossification occurring over a prolonged time after a unilateral knee injury. An 84-year-old Japanese man with a spinal cord injury caused by a burst fracture of the T12 vertebra presented with a bony hard prominence on the left knee, which was injured in a traffic accident when he was 77 years old. Radiography revealed extensive ossification of the bilateral patellar tendons. We review the English literature with a focus on the localization of bilateral heterotopic ossification of the knee in patients who had a central nervous system injury...
February 2018: Acta Medica Okayama
Lei Tan, Tiejun Wang, Yan-Hui Li, Tianye Yang, Baohui Hao, Dong Zhu, Da-Hui Sun
RATIONALE: Retrograde femoral nailing was one of the most important treatment means for distal femoral shaft fracture. However, studies regarding heterotopic ossification of the patellar tendon after retrograde intramedullary nailing for distal femoral shaft fracture are limited. We herein present a rare complication, namely heterotopic ossification of the patellar tendon, after retrograde intramedullary nailing for displaced femoral shaft fracture. PATIENT CONCERNS: We present a case of 25-year-old male with displaced femoral shaft fracture who was treated by retrograde intramedullary nailing...
November 2017: Medicine (Baltimore)
Shen Hwa Vun, David William Shields, Aroop Sen, Sajan Shareef, Satyajit Sinha, Alexander Craig Campbell
BACKGROUND: Adequate range of knee motion is critical for successful total knee arthroplasty. While aggressive physical therapy is an important component, manipulation may be a necessary supplement. There seems to be a lack of consensus with variable practices existing in managing stiff postoperative knees following arthroplasty. Hence we aim to determine the current practice and trend among knee surgeons throughout the United Kingdom. MATERIALS AND METHODS: Postal questionnaires were sent out to 100 knee surgeons registered with British Association of Knee Surgeons, ensuring that the whole of United Kingdom was well represented...
December 2015: Journal of Orthopaedics
Michele Arcangelo Verdano, Matteo Zanelli, Davide Aliani, Tiziana Corsini, Andrea Pellegrini, Francesco Ceccarelli
BACKGROUND: quadriceps tendon subcutaneous rupture is an uncommon injury affecting predominantly middle-aged men as a result of direct or indirect trauma; aim of this work is to evaluate clinical outcome and tendon morphology in patients treated surgically with transpatellar drilling suture. METHODS: 20 patients (20 male) with an average age of 54 (42-59) were evaluated with a mean follow-up of 36 months. Measurements of range of motion (ROM) and of tight circumference were collected...
April 2014: Muscles, Ligaments and Tendons Journal
Bhaskara Bhandary, Sudeep Shetty, Vinay V Bangera, Yogaprakash R, Mohammed Shabir Kassim, Karan Alva, Sudarshan Bhandary
INTRODUCTION: Previous studies have enumerated the advantages of an arthroscopic Anterior Cruciate Ligament (ACL) reconstruction with the use of a Bone Patellar Tendon Bone (BPTB) graft. Complications are extremely rare in such surgeries and one such known complication, which is an extra-articular heterotophic ossification at the femoral tunnel site, is rarely seen only in few patients. AIM: To evaluate the incidence of heterotrophic ossifications at the femoral tunnel site and the efficacy of the preventive measures which were undertaken, in patients who had undergone ACL reconstructions with the use of bone patellar tendon bone grafts...
May 2013: Journal of Clinical and Diagnostic Research: JCDR
Gianluca Camillieri, Vincenzo Di Sanzo, Matteo Ferretti, Cosma Calderaro, Vittorio Calvisi
BACKGROUND: Among the various complications described in literature, the patellar tendon ossification is an uncommon occurrence in anterior cruciate ligament (ACL) reconstruction using bone - patellar tendon - bone graft (BPTB). The heterotopic ossification is linked to knee traumatism, intramedullary nailing of the tibia and after partial patellectomy, but only two cases of this event linked to ACL surgery have been reported in literature. CASE PRESENTATION: We present a case of a 42-year-old Caucasian man affected by symptomatic extended heterotopic ossification of patellar tendon after 20 months from ACL reconstruction using BPTB...
May 10, 2013: BMC Musculoskeletal Disorders
Mehmet Erdil, Mehmet Aşık, Cengiz Sen, Gökhan Polat
In this study, we present a 36-year-old male patient who developed heterotopic ossification after anterior cruciate ligament (ACL) reconstruction performed using bone-patellar tendon-bone autograft harvested from the 1/3 middle part of the patellar tendon. This ossified part, which restricted range of motion of the affected knee, was excised surgically 1 year after diagnosis. Physical examination, conducted 36 months later, revealed the achievement of full range of motion without any complaints or recurrences...
2012: Acta Orthopaedica et Traumatologica Turcica
Yun Feng Rui, Pauline Po Yee Lui, Christer Gustav Rolf, Yin Mei Wong, Yuk Wa Lee, Kai Ming Chan
PURPOSE: The pathogenesis of patellar tendinopathy remains unclear. Expression of BMP-2/-4/-7 was reported in an ossified failed tendon healing animal model of patellar tendinopathy. This study aimed to investigate the expression of these chondro-osteogenic BMPs in clinical samples of patellar tendinopathy. METHODS: Patellar tendon samples were collected from 16 consecutive patients with patellar tendinopathy and 16 consecutive controls undergoing anterior cruciate ligament reconstruction with bone-patellar tendon-bone autograft in the authors' hospital after getting their consent...
July 2012: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Austin Chen, Samuel Chmell
INTRODUCTION: Heterotopic ossification is the abnormal formation of lamellar bone in soft tissue. Its presence jeopardizes functional outcome, impairs rehabilitation and increases costs due to subsequent surgical interventions. CASE PRESENTATION: We present a case of a 32-year-old African-American man with trisomy 8 mosaicism who developed severe heterotopic ossification of his right extensor mechanism subsequent to repair of a patellar tendon rupture. CONCLUSION: To the best of our knowledge there are no prior reports of heterotopic ossification as a complication of patellar tendon repair...
2011: Journal of Medical Case Reports
Pauline Po Yee Lui, Yau Chuk Cheuk, Yuk Wa Lee, Kai Ming Chan
The acquisition of chondro-osteogenic phenotypes and erroneous matrix deposition may account for poor tissue quality after acute tendon injury. We investigated the presence of chondrocyte phenotype, ossification, and the changes in the expression of major collagens and proteoglycans in the window wound in a rat patellar tendon window injury model using histology, von Kossa staining and immunohistochemistry of Sox 9, major collagens, and proteoglycans. Our results showed that the repair tissue did not restore to normal after acute injury...
January 2012: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Ronald Damani Howell, Ji Hae Park, Kenneth A Egol
This article describes a case of a 21-year old man who presented with symptomatic heterotopic ossification of the patellar tendon 3.5 years postinjury. The patient sustained an open tibia fracture during a fall and was treated by reamed intramedullary nailing through a medial paratendinous approach. Radiographic evidence of heterotopic ossification in the patellar tendon was first noted at the 4-week follow-up. He presented at 3.5 years postinjury with new-onset anterior knee pain and reported no interval trauma to the knee...
March 11, 2011: Orthopedics
T Kilts, L Ameye, F Syed-Picard, M Ono, A D Berendsen, A Oldberg, A-M Heegaard, Y Bi, M F Young
We present a detailed comparison of ectopic ossification (EO) found in tendons of biglycan (Bgn), fibromodulin (Fmod) single and double Bgn/Fmod-deficient (DKO) mice with aging. At 3 months, Fmod KO, Bgn KO and DKO displayed torn cruciate ligaments and EO in their quadriceps tendon, menisci and cruciate and patellar ligaments. The phenotype was the least severe in the Fmod KO, intermediate in the Bgn KO and the most severe in the DKO. This condition progressed with age in all three mouse strains and resulted in the development of large supernumerary sesmoid bones...
August 2009: Scandinavian Journal of Medicine & Science in Sports
Pauline Po-yee Lui, Sai-chuen Fu, Lai-shan Chan, Leung-kim Hung, Kai-ming Chan
We report chondrocyte phenotype and ectopic ossification in a collagenase-induced patellar tendon injury model. Collagenase or saline was injected intratendinously in one limb. The patella tendon was harvested for assessment at different times. There was an increase in cellularity, vascularity, and loss of matrix organization with time after collagenase injection. The tendon did not heal histologically until week 32. Ectopic mineralization as indicated by von Kossa staining started from week 8. Tendon calcification was mediated by endochondral ossification, as shown by expression of type X collagen...
February 2009: Journal of Histochemistry and Cytochemistry: Official Journal of the Histochemistry Society
Rami Hussein, Jonathan Miles, Nicholas Garlick, George Simon Edmund Dowd
Various techniques have been described for the treatment of soft tissue extension contracture of the knee. Some involve large exposures, and others can result in a permanent extensor lag. We describe a technique with limited exposure, avoiding transverse incisions in the rectus femoris. Through a midline incision, the extensor expansion is exposed. The rectus femoris is separated from the vastus medialis, lateralis, and intermedius to form a strap-like structure. Vastus intermedius is separated from the patella...
January 2008: Journal of Knee Surgery
C Haasper, M Jagodzinski, J Geerling, A L Cordes, C Krettek, R Gaulke
Ruptures of the patellar tendon are less often observed compared to those of the Achilles or quadriceps tendon. A bilateral rupture is a rarity. Steroid medications or a variety of systemic diseases are associated with spontaneous tendon ruptures. Less often traumatic rupture is the result of severe overloading of the extensor mechanism of the knee. We report on a 60-year-old female without an obvious trauma, systemic disease or medication who suffered a spontaneous bilateral patellar tendon rupture.
September 2007: Zeitschrift Für Orthopädie und Unfallchirurgie
S B Sesia, C-C Hasler, M Köhler, J Mayr
In children, avulsion fractures of the patella are observed more frequently than ruptures of the quadriceps tendon. In cases of suspected lesions of the quadriceps tendon, conventional x-ray imaging and ultrasound comparison of both patellae is recommended. Arthroscopy is helpful for diagnosing concomitant intra-articular knee lesions and permits evacuation of the hemarthrosis.
October 2007: Der Unfallchirurg
Jung-Ro Yoon, Taik Sun Kim, Hak Jun Kim, Haeng-Kee Noh, Jong Keon Oh, Jae Chul Yoo
We present a simultaneous patella tendon avulsion fracture from both sides of its attachment in an ectopic ossified patellar tendon. Medially two thirds of the patellar tendon was detached from the inferior patella, and laterally one third of that from anterior tibial tuberosity with the patellar tendon split. Osteosynthesis was used to restore the extensor mechanism of the knee. The result at 46 months was good, even though there were some remaining ectopic ossifications in the patellar tendon.
March 2007: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Homero Valencia, Carlos Gavín
Reconstruction of the anterior cruciate ligament (ACL) is currently a common procedure. We report a case of ACL reconstruction using an autologous patellar tendon graft, where great infrapatellar heterotopic ossification occurred post-operatively. We found no similar cases in the literature. We discuss about the probable origin.
January 2007: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
J R W Hardy, M Chimutengwende-Gordon, I Bakar
We reviewed the records of 107 consecutive patients who had undergone surgery for disruption of the knee extensor mechanism to test whether an association existed between rupture of the quadriceps tendon and the presence of a patellar spur. The available standard pre-operative lateral radiographs were examined to see if a patellar spur was an indicator for rupture of the quadriceps tendon in this group of patients. Of the 107 patients, 12 underwent repair of a ruptured patellar tendon, 59 had an open reduction and internal fixation of a patellar fracture and 36 repair of a ruptured quadriceps tendon...
October 2005: Journal of Bone and Joint Surgery. British Volume
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