Patellar tendon ruptures repaired through a simple modified reconstruction using hamstrings tendon graft in obese patient: surgical technique and case report

Background: Patellar tendon ruptures are uncommon, severe, and are complex cases that require early surgical intervention. Loss of function of the extensor mechanism of the knee joint might cause severe disability and inability to hold a standing position. Case Presentation: A 34-year-old Saudi male, known to have morbid obesity (class 1), came to the emergency room complaining of severe pain in the left knee after experiencing a fall on a flexed knee while playing soccer. The patient had no other significant past medical history. In this case, the injury occurred due to a minor sports accident, and there were no predisposing factors. Thus, it was decided to do patellar tendon augmented reconstruction using a pedicled hamstring tendon, involving primary repair. After the surgery, a cast was applied on the patient's knee and retained for 3 weeks, allowing only active knee flexion and passive extension. Then, active assisted knee extension was allowed through physiotherapy for 2 months, until 75%-80% of active extension was achieved. Patient was moved to out-patient department after 3 months for further assessment. Conclusion: Patellar tendon ruptures from the tibial tuberosity are quite uncommon. When the patient has morbid obesity, acute repair of the patellar tendon through reconstruction using hamstring tendons could give a positive result with good outcome in the joint's movement.