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Case Reports
. 2022 Nov 8:23:e937689.
doi: 10.12659/AJCR.937689.

Combined Rupture of the Right Anterior Cruciate Ligament and Patellar Tendon on a 28-Year-Old Spanish Professional Handball Player Successfully Treated by Single-Stage Reconstructive Surgery

Francisco Selva-Sarzo  1 , Luis Ignacio Nebot-Sanchis  2
Affiliations
Case Reports

Combined Rupture of the Right Anterior Cruciate Ligament and Patellar Tendon on a 28-Year-Old Spanish Professional Handball Player Successfully Treated by Single-Stage Reconstructive Surgery

Francisco Selva-Sarzo et al. Am J Case Rep. .

Abstract

BACKGROUND We present a case of combined rupture of the right anterior cruciate ligament (ACL) and patellar tendon (PT) in a 28-year-old professional handball player that was successfully treated by single-stage reconstructive surgery. The combined rupture of the ACL and PT is a rare injury pattern, and there are only a few cases reported in the literature. Presently, little evidence exists to guide management decisions for these patients. In comparison to isolated injuries, the combined rupture of the PT and ACL presents many management dilemmas. CASE REPORT A professional handball player from the Valencia Handball Club in the Spanish ASOBAL league had a rupture of the PT, ACL, medial collateral ligament, and medial meniscus in May 2004. A PT and ACL reconstruction was performed in a single-stage surgery. The patient returned to the sport and had no complications. He retired from professional competition after the 2016-17 season. Until follow-up in May 2021, he continued to be stable and without symptoms, remaining completely free of pain and arthrofibrosis, and the patella was centered. CONCLUSIONS Single-stage reconstruction of the PT and ACL in an elite-level athlete facilitated the continuation of his performance at the highest level of the sport. To the best of our knowledge, this is the only published case of a PT and ACL reconstruction in a single-stage surgical procedure that resulted in the patient making a full return to playing handball in Spain at an elite level. This case has important implications for sports medicine and sports physiotherapy.

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Conflict of interest statement

Conflict of interest: None declared

Figures

Figure 1.
Figure 1.
T2 graft using tendons from the semitendinosus and gracilis muscles for the reconstruction of the anterior cruciate ligament (asterisk) and total break of the patellar tendon (arrow).
Figure 2.
Figure 2.
Platelet growth factor used to accelerate the healing and biological repair of the patellar tendon (arrow) and reinforcement of patellar tendon (asterisk).
Figure 3.
Figure 3.
Cerclage wire used to protect the patellar tendon repair (arrow).
Figure 4.
Figure 4.
After the first week of reconstruction, the application of electroanalgesia was started.
Figure 5.
Figure 5.
The scar caused after reconstruction of the knee before mobilizing to elasticize it and improve functionality.
Figure 6.
Figure 6.
Non-weight-bearing proprioception exercises in a pool to improve joint mobility without overloading the repaired structures.
Video 1.
Video 1.
Harmful action.
See this image and copyright information in PMC

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References

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