Simultaneous patellar tendon and anterior cruciate ligament rupture: a systematic review, meta-analysis and algorithmic approach

• Published in: Archives of orthopaedic and trauma surgery 2024-12, Vol.145 (1), p.61
• Main Authors: Ismailidis, Petros, Neopoulos, Georgios, Egloff, Christian, Mündermann, Annegret, Halbeisen, Florian S., Nüesch, Corina, Appenzeller-Herzog, Christian, Müller, Sebastian A.
• Format: Article
• Language: English
• Subjects: Algorithms; Anterior Cruciate Ligament Injuries - complications; Anterior Cruciate Ligament Injuries - surgery; Anterior Cruciate Ligament Reconstruction - methods; Decision making; Humans; Injuries; Magnetic Resonance Imaging; Medicine; Medicine & Public Health; Orthopedics; Patellar Ligament - diagnostic imaging; Patellar Ligament - injuries; Review; Rupture - surgery; Systematic review
• ISSN: 0936-8051; 1434-3916; 1434-3916
• DOI: 10.1007/s00402-024-05676-w

Introduction Isolated patellar tendon (PT) or anterior cruciate ligament (ACL) ruptures are common injuries, yet the co-occurrence of both presents a rare challenge for clinicians. The objectives of the study are to document diagnostic and therapeutic approaches, outcomes, and complications of combined PT and ACL injuries and to develop an algorithm to guide clinicians in decision-making. Methods The systematic review und metanalysis was conducted according to the PRISMA guidelines. Studies reporting on simultaneous PT and ACL ruptures were included. Meta-analysis was performed to compare different diagnostic modalities and treatment strategies. Results Thirty-six studies reporting on 56 Patients were included. 88% of patients had a concomitant injury (apart from PT and ACL) to the ipsilateral knee. Part of the diagnosis was missed in 23% of the cases. Performance of MRI significantly reduced the risk of missing a part of the injury (5% with MRI vs 69% without MRI, p