[Modified Z-plasty of the patellar tendon for patella baja and flexion deficits].

IF 1 4区医学 Q3 ORTHOPEDICS

Operative Orthopadie Und Traumatologie Pub Date : 2025-01-23 DOI:10.1007/s00064-024-00886-2

Wolf Petersen, Hasan Al Mustafa, Johanna Schulze Borges, Martin Häner

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引用次数: 0

Abstract

Objective: Lengthening of the patellar tendon to normalize patellar height and improve knee flexion deficits.

Indications: Flexion deficits in combination with patella baja (Caton index < 0.6).

Contraindications: Infection.

Surgical technique: Arthroscopy of the knee and resection of adhesions in suprapatellar pouch and additional intraarticular adhesions. Approximately 15 cm long incision from tibial tuberosity up to the patella. Exposition of the patellar tendon. Longitudinal incision in the middle from the tibial tuberosity towards the proximal patella. Division of the tendon into two strands. Detachment of the lateral tendon strand with periosteum from the bone of the patella and detachment of the medial strand with periosteum from the bone of the tibial tuberosity. Resection of fibrotic adhesions within Hoffa's fad pad and detachment of the longitudinal retinacula. Lengthening of the patella tendon of maximal 2.5 cm. Refixation of the medial strand to the upper part of the tibial tuberosity and the lateral strand to the distal patella pole with a soft anchor. Drilling of small transverse bone tunnels in the patella and tibial tuberosity for application of a McLaughlin cerclage for augmentation of the z‑plasty with a thick braided suture cord.

Postoperative management: Six weeks partial weight bearing with 10 kg within a straight leg brace. Free passive range of motion.

Results: Previously published results show that the Z‑plasty technique presented here on the patellar tendon can normalize the Caton index and improve mobility and clinical scores.

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来源期刊

Operative Orthopadie Und Traumatologie ORTHOPEDICS-

CiteScore

2.10

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： Orthopedics and Traumatology is directed toward all orthopedic surgeons, trauma-tologists, hand surgeons, specialists in sports injuries, orthopedics and rheumatology as well as gene-al surgeons who require access to reliable information on current operative methods to ensure the quality of patient advice, preoperative planning, and postoperative care. The journal presents established and new operative procedures in uniformly structured and extensively illustrated contributions. All aspects are presented step-by-step from indications, contraindications, patient education, and preparation of the operation right through to postoperative care. The advantages and disadvantages, possible complications, deficiencies and risks of the methods as well as significant results with their evaluation criteria are discussed. To allow the reader to assess the outcome, results are detailed and based on internationally recognized scoring systems. Orthopedics and Traumatology facilitates effective advancement and further education for all those active in both special and conservative fields of orthopedics, traumatology, and general surgery, offers sup-port for therapeutic decision-making, and provides – more than 30 years after its first publication – constantly expanding and up-to-date teaching on operative techniques.