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simultaneous rupture of the anterior cruciate ligament and patellar tendon, a rare lesion ski accident:

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simultaneous rupture of the anterior cruciate ligament and patellar tendon, a rare lesion ski accident about two

The simultaneous ACL and patellar tendon during a skiing accident, is a rare lesion. The initial diagnosis is often difficult and there is no consensus on treatment. We present 2 patients who experienced ACL injuries, patellar tendon and meniscus following a skiing accident

Clinical case:

The first case was a 43-year-old suffered a skiing accident with injury in his right knee. The diagnosis was initially posed a serious knee sprain with isolated ACL tear. The initial treatment was orthopedic. In the absence of clinical improvement, the patient took a second opinion. Clinical examination was difficult with a knee inexaminable, widespread pain and a large hematoma. MRI (done at 28 days) showed a complete rupture of LCAE, a laceration of the patellar tendon, peripheral avulsion internal and external meniscus. The patient was operated on urgently: repair and suturing of the patellar tendon, exploration knee arthroscopy, excision of ACL fibers and bi-meniscal suturing. After rehabilitation and consolidation, a second procedure was performed 8 months later with type hamstring ligament. The postoperative protocol and rehabilitation were the same as for an isolated LCAE. A 3 year follow-up, the patient has recovered a normal knee.
The second case was almost identical after a skiing accident in a woman of 24 years. The initial diagnosis was also an isolated lesion LCAE. The MRI done at 10 days showed a lesion LCAE associated with a laceration of the patella tendon, a double meniscal tear and damage LLI. The treatment took place in 2 stages with repair of the patellar tendon and suture the two menisci in emergency then type hamstring ligament in 6 months. At last follow 2 years she has a good functional outcome.

Conclusion:

The simultaneous rupture of the patellar tendon and LCAE is very rare and poorly known. There are very few cases in the published literature. The initial diagnosis is often not made and requires urgent MRI. The operating program should be in two stages to prevent fibrosis and postoperative stiffness after complex knee surgery. In these 2 patients supported their have given satisfactory results.

Doctor Nicolas LEFEVRE, Doctor Serge HERMAN, Doctor St├ęphane CASCUA. - 25 janvier 2011.

Conflicts of interest: the author or authors have no conflicts of interest concerning the data published in this article.

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