Chronic Midsubstance Patellar Tendon and Retinacular Rupture: Primary Repair Enhancement Using Bioinductive Implant Augmentation.

Abstract

Midsubstance tears of the patellar tendon are uncommon and present a difficult injury to treat. If left untreated, these can be debilitating injuries for patients and leave them with an overall lack of function in the injured extremity. Compared to a proximal or distal patellar tendon rupture, midsubstance tears rely on tendon-to-tendon healing instead of bone to tendon healing. Given this situation, specific preoperative planning and the use of a bioinductive scaffolding allows surgeons to enhance the overall construct, while promoting a beneficial healing environment. Although the addition of bioinductive implants has grown in popularity for upper extremity injuries, few cases describe its use in the lower extremity setting. Here, we present a case of midsubstance patellar tendon repair, as well as a medial and lateral retinacular repair using a structural biological implant with Type I collagen for augmentation to enhance our overall final construct.