Review Question - QID 506

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ACL Tear Graft Selection Bone-patellar tendon-bone (BPTB) autograft QID: 506 (OBQ08.120)

QID 506 (Type "506" in App Search)

A 25-year-old male undergoes an ACL reconstruction with an ipsilateral bone-patella tendon-bone autograft. At his two week followup he is noted to have complete loss of his extensor mechanism on exam, stable Lachman and posterior drawer tests, and patella alta radiographically. Management should consist of?

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Continued standard ACL rehab protocol

40/1395

Quadraceps tendon repair

33/1395

WBAT in a cylinder cast

11/1395

Patellar tendon repair or reconstruction

93%

1295/1395

Revision ACL reconstruction with hamstring autograft

8/1395

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Patellar tendon rupture is a rarely reported complication of using a bone-patella tendon-bone (BPTB)autograft in ACL reconstruction. Most cases have been reported in the early post-operative period and should be treated with patellar tendon repair or reconstruction to restore the extensor mechanism. The reference from Cain et. al details management options for intraoperative complications of patella tendon grafts.

The reference from Lee et.al demonstrated a 0.2% complication rate from BPTB harvest including 2 patella fractures and 1 patellar tendon rupture treated with reconstruction.