Successful surgery for patient with rare knee injury

The knee joint is the largest joint in the human body and is one of the most commonly injured joints. Common injuries to the knee joint include: sprains, torn ligaments, torn meniscus, tendon injuries, fractures, dislocations...

Image of the concave area where the patient's tendon was torn. Photo: Kim Chung

The patellar tendon is the tendon that connects the patella and tibia, and plays an important role in the knee joint's extension system. Patellar tendon rupture is one of the rare knee injuries. Closed patellar tendon rupture is an injury that can occur at any age, especially in track and field athletes and high jumpers. When a person playing sports or doing daily activities is injured by a strong impact force, directly to the front of the knee, the foot lands in a bent knee position, suddenly flexing and extending too much. Usually after the injury, it is not possible to actively perform knee extension movements, most knee joints do not swell much, so patients are often subjective, thinking it is a simple injury and do not go to medical facilities for examination. This makes the injury more and more severe, affecting daily movement and activities.

Image of a patient unable to fully extend his left knee due to patellar tendon injury. Photo: Kim Chung

Patient TMH, 15 years old, in Van Loi commune, Quy Hop district, Nghe An, showed abnormal symptoms in the left knee area after playing soccer 1.5 months ago. When examining the knee joint, the doctor determined that the patient had clinical patellar tendon injuries: A continuous concave area was palpated right at the lower pole of the patella (where the tendon was torn); The patella was higher than normal (compared to the healthy leg); Walking with a limp and unable to fully extend the knee.

To confirm the diagnosis, the patient was ordered to have an X-ray showing the patella higher than normal position and an MRI of the left knee joint. The result was a complete tear at the middle 1/3 of the patellar tendon.

A team of doctors from Vinh International Hospital performed tendon reconstruction surgery on a patient. Photo: Kim Chung

Tendon reconstruction surgery is appropriate in this case. Orthopedic specialist Tran Van Thuyen applies the technique of reconstructing the torn patellar tendon using autologous Hamstrings tendon grafts (gracilis and semitendinosus tendons). The doctor exposes the patella and the damaged area under the patella, cleans the fibrous tissue, then takes the Hamstrings tendon (maintaining the attachment point), measures the diameter of the tendon, drills a tunnel (the tunnel diameter depends on the measured Hamstrings tendon size) through the tibial convexity, and threads the Hamstrings tendon from the inside out. Next, drills a tunnel through the patella from the outside in, threads the new tendon through the patellar tunnel, returns the patella to its normal position and fixes it at the position of the tendon; temporarily immobilizes the knee joint with a long knee brace.

The surgery was successful after 45 minutes. After surgery, the patient's knee was immobilized with a knee brace in a straight position for 4-6 weeks. The doctor instructed the patient to exercise in the brace, while preserving the graft and increasing the strength of the tendons and muscles around the knee, while gradually bearing the body weight, from lightly touching the toes, to the feet, part of the body and the whole body according to the instructions of the surgeon. Usually after 6 months, the movement is restored and all normal activities are returned.

X-ray images before and after tendon reconstruction surgery for a patient with a torn patellar tendon. Photo: Kim Chung

To minimize injuries while playing sports, doctors recommend ensuring the following principles are properly and fully implemented: Wear full safety gear; Perform all warm-up exercises; Exercise moderately, do not overexert or become exhausted; Stretch slowly.

For detailed information and advice, please contact:

Vinh International Hospital

No. 99, Pham Dinh Toai Street, Nghi Phu Commune, Vinh City, Nghe An

Phone number 02383.968.888/0901.74.71.73