Patella Tendon Reconstruction After 6 Years of Neglected Rupture in an Active Young Male.

Abstract

This case report highlights the staged surgical reconstruction of a neglected patellar tendon rupture in a young male 6 years post-injury, using patella traction plus an ipsilateral hamstring autograft in a resource-limited setting. A 22-year-old male presented with chronic (6 years) patellar tendon rupture, evidenced by patella alta, quadriceps atrophy, and loss of active knee extension. Preoperative traction was applied to reduce the proximally migrated patella, followed by surgical procedures which included quadricepsplasty, adhesiolysis, and reconstruction with semitendinosus and gracilis tendon autografts. The grafts were securely fixed through bone tunnels in the patella and tibia. Postoperative rehabilitation involved immobilization in a hinged knee brace, quadriceps strengthening exercises, and a progressive range-of-motion protocol. At 12 weeks post-surgery, the patient regained active knee extension and achieved a functional knee range of motion from - 5° to 100° indicating a successful restoration of the extensor mechanism and knee function. Rehabilitation is still ongoing, with continued progress in mobility and strength. This case demonstrates that ipsilateral hamstrings autograft, combined with preoperative traction and quadricepsplasty, is an effective solution for chronic patellar tendon ruptures in resource-limited environments. It offers a feasible alternative to allografts, reducing donor-site morbidity while restoring knee function in neglected cases.