Introduction:
Pre-existing conditions and surgical interventions, such as those associated with Osgood-Schlatter disease, can lead to atypical patellar tendon ruptures. These cases can present irregularly and be challenging to diagnose. Patellar tendon rupture from the tibial tubercle insertion region is a rare, and currently undocumented condition, requiring surgical intervention to restore knee joint functionality for daily activities. This presentation requires a unique treatment approach, as standard reconstruction techniques do not apply.
Case report:
A 65-year-old Caucasian male, with a remote history of gout and surgical intervention for symptomatic Osgood-Schlatter disease, suffered sudden hyperflexion with eccentric contraction of the right knee while hiking. The patient presented with massive right knee effusion and significant tenderness over the tibial tubercle, with an inability to extend the knee. After radiographs were inconclusive, magnetic resonance imaging was performed showing a tear of the medial aspect of the distal patellar tendon.
Conclusion:
Surgical intervention for Osgood-Schlatter disease can be a potential risk factor for patellar tendon rupture from the tibial tubercle. Since a variety of surgical interventions for symptomatic Osgood-Schlatter disease exist, it is important to consider the long-term effects and counsel patients on the associated risks of the procedures. Initial diagnosis of patellar tendon rupture can be surprisingly challenging when the presentation is atypical. Attention to detail during physical examination and evaluation of imaging is a necessity for early detection and treatment, which can afford excellent functional outcomes.