Extensive Bilateral Patellar Tendon Ossification in a Spinal Cord Injury Patient (original) (raw)
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Massive Patellar Tendon Ossification: Excision and Simultaneous Total Knee Replacement
Tendon ossification has a multifactorial aetiology. We present a case of a massive ossification within the substance of patellar tendon. A 79-years-old male who had a previous history of patellar tendon rupture and its surgical repair. He gradually developed a large bony mass within the patellar tendon and progressive symptoms of arthritis in the knee joint. The patient underwent a total knee replacement along with simultaneous excision of the entire bony lump and primary repair of the patellar tendon. The knee was mobilised gradually after surgery and achieved satisfactory range of motion, function and alleviation of symptoms without any complication.
Patellar tendon ossification after partial patellectomy: a case report
Journal of Medical …, 2010
Introduction: Patellar tendon ossification is a rare pathology that may be seen as a complication after sleeve fractures of the tibial tuberosity, total patellectomy during arthroplasty, intramedullary nailing of tibial fractures, anterior cruciate ligament reconstruction with patellar tendon autograft and knee injury without fracture. However, its occurrence after partial patellectomy surgery has never been reported in the literature. Case presentation: We present the case of a 35-year-old Turkish man with a comminuted inferior patellar pole fracture that was treated with partial patellectomy. During the follow-up period, his patellar tendon healed with ossification and then ruptured from the inferior attachment to the tibial tubercle. The ossification was excised and the tendon was subsequently repaired. Conclusion: To the best of our knowledge, this is the first report of patellar tendon ossification occurring after partial patellectomy. Orthopaedic surgeons are thus cautioned to be conscious of this rare complication after partial patellectomy.
Cureus, 2019
A 33-year-old male victim of a motor vehicle accident, who presented with a T12 (thoracic 12 vertebra) burst fracture (ISNCSCI T11 AIS-A: International Standards for Neurological Classification of Spinal Cord Injury T11 ASIA Impairment Scale), was admitted to a rehabilitation hospital. A stage-II left ischial pressure ulcer was also reported. An X-ray of the pelvis revealed bilateral neurogenic heterotopic ossification (NHO) in both hips and knees, which was further confirmed by TC-99m methylene diphosphonate (MDP) bone scintigraphy. Interventions included indomethacin and conservative management. Surgery was not preferred, as NHO was still immature. Moreover, patient transfer and lower body dressing were unaffected by NHO. It is important to consider an early radiological screen in selected high-risk cases for NHO, to minimize the risk of associated complications.
Spinal Cord Series and Cases, 2019
Study design This was a single-centre, retrospective, descriptive, hospital-based study in persons with spinal cord injuries (SCI) patients. Objectives To study the incidence and characteristics of heterotopic ossification (HO) after SCI. Setting The in-patient services of the Department of Physical Medicine and Rehabilitation of a tertiary care institute in India between January 2001 and December 2017. Methods Medical records of all consecutive patients with diagnosis of SCI in the age group of 15-60 years were reviewed for presence of HO (diagnosed by clinical signs, laboratory investigations (ALP, ESR and X-rays)) and characteristics of HO. R-Ver 3.4.2 was used for analysis and correlations. Results were considered significant at P < 0.05. Results A total of 303 patients satisfied inclusion criteria. Nineteen individuals (6.3%) had developed HO. Seven (37%) were diagnosed within 3 months of SCI. Twelve (63%) patients developed unilateral HO. The most common site for HO was hip joint (73%). A significant association was found between the presence of a pressure ulcer and development of HO (P = 0.01). Conclusions The incidence of HO was 6.3% in our institution and the hip joint is the most common site. Due to the presence of limited treatment options it is important to diagnose HO early in patients with SCI based on clinical features and later confirmed with laboratory tests and imaging.
Patellar Tendon Ossification or Reformation of Patella after Partial Patellectomy? A Case Report
Global journal of surgery, 2014
We present a curious case of spontaneous reformation of patella/patellar tendon ossification after partial patellectomy. This is a very rare pathology that has been reported as a complication after sleeve fractures of the tibial tuberosity, total patellectomy during total knee arthroplasty, intramedullary nailing of tibial fractures, anterior cruciate ligament reconstruction with patellar tendon autograft and knee injury without fracture. Patellar tendon ossification after partial patellectomy has been reported just once in literature. We present the second one of this nature. The patellar tendon ossification resembled a reformation of the patella and could easily be mistaken for an inadequate removal of the patellar remnant.
Medical ultrasonography, 2011
Ossification of the Achilles tendon is a rare clinical condition characterized by the presence of one or more segments of variable sized ossified mass within the tendon. The cause of the condition is obscure. We present the case of a 41 year-old male patient with pain in the Achilles tendon due to bilateral ossification of the tendon near the calcaneus insertion. The case was evaluated by ultrasonography, single photon emission computed tomography, and transmission computed tomography. In this case, we regarded repetitive microtrauma as the cause of the ossification based on the bilateral occurrence.
Ossification of the bilateral Achilles tendon: a rare entity
Acta Radiologica Open, 2015
Ossification of the Achilles tendon is a rare clinical entity comprising of one or more segments of variable sized ossified masses in the fibrocartilaginous substance of the tendon. The etiology of ossification of the Achilles tendon is multifactorial with recurrent trauma and surgery comprising major predisposing factors, with others being metabolic, systemic, and infectious diseases. The possibility of a genetic predisposition towards this entity has also been raised, but has not yet been proven. We present a rare case of ossification of the bilateral Achilles tendons without any history of trauma or surgery in a 48-year-old female patient.
2010
Spinal cord injury is a well-known predisposing factor for development of heterotopic ossification around the joints especially hip and elbow. Heterotopic ossification about the knee is usually located medially, laterally or anteriorly; besides, the knee is generally fixed in flexion. There are only a few reports of heterotopic bone formation at the posterior aspect of the knee (popliteal space) and fixation of both knees in extension; so, there is little experience in operative management of such a problem. Here, we present a 39-years old paraplegic man who was referred to us five years after trauma with a request of above knee amputation due to sever impairment of his life style and adaptive capacity for daily living because of difficulties in using wheelchair. The principle reason for the impairment was fixed full extension of both knees as the result of bilateral large heterotopic ossification masses in popliteal fossae. The bony masses were surgically resected with acceptable outcome. The anatomic position of the ossified masses as well as ankylosis of both knees in full extension, and the acceptable functional outcome of surgery which was done after a long period of five years following injury makes this case unique.