Painful patellofemoral instability secondary to peroperative patellar fracture during bone-patellar tendon-bone autograft harvesting for anterior cruciate ligament reconstruction - 02/10/12

Doi : 10.1016/j.otsr.2012.05.008

C. Vidal ^⁎ , O. Guingand, E. de Thomasson, C. Conso, R. Terracher, L. Balabaud, C. Mazel
Orthopedic Surgery Department, institut mutualiste Montsouris, Paris XIII University, 42, boulevard Jourdan, 75014 Paris, France

Corresponding author. Tel.: +33 06 72 96 68 66.

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Summary

Reconstructive surgery of the anterior cruciate ligament (ACL) of the knee in young active patients is a routine procedure, but with certain risks that need to be taken into account. Peroperative patellar fracture after bone-patellar tendon-bone autograft harvesting is a rare complication, which can significantly impair the functional outcome of ACL single-bundle reconstruction. We report the case of a patient presenting with disabling patellofemoral syndrome 3 years after arthroscopic ACL reconstruction by bone-tendon-bone autograft, revealing unnoticed mal-union of a iatrogenic sagittal patellar fracture. Patellar osteotomy corrected this painful iatrogenic patellar instability.

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Keywords : Iatrogenic patellar fracture, Bone-patellar tendon-bone autograft, Sagittal patellar osteotomy, Anterior cruciate ligament reconstruction