Komplikacija nakon rekonstrukcije zastarele rupture ligamenta čašice
Sažetak
Uvod. Hronične rupture patelarne tetive (RPT) su retke, a učestalost i prevalenca su nepoznati. Podaci o kasnoj rekonstrukciji patelarne tetive kod reumatoidnog artritisa i njenim komplikacijama su oskudni. Prikaz bolesnika. Prikazali smo operativnu tehniku rekonstrukcije jedanaest meseci stare rupture ligamenta patele 21-godišnje bolesnice sa juvenilnim reumatoidnim artritisom i ranom postoperativnom komplikacijom ‒ rupturom kontralateralnog ligamenta patele sa kog je uzet kost-tetiva-kost autograft. Koristili smo kost-tetiva-kost autograft i alograftove sa duplim žičanim ojačanjima uz postoperativnu mobilizaciju. Bolesnica je praćena u periodu od 2 godine pri čemu je funkcija oba kolena kompletno rekonstruisana, sa punim obimom pokreta. U ovom slučaju, rekonstrukcija 11 meseci stare, hronične RPT (sa kompletnom resorpcijom patelarne tetive i kompletnom separacijom masnog jastučeta kolena, komplikovanom kontralateralnom RPT) sa kost-tetiva-kost autograftom i alograftom i sa duplim žičanim ojačanjima, dala je odličan funkcionalni rezultat. Dve godine nakon operativnog lečenja, funkcija oba kolena (oba ekstenzorna aparata) je u potpunosti obnovljena sa punim aktivnim obimom pokreta i bolesnica nema strah dok hoda stepenicama, niti koristi ortopedska pomagala. Zaključak. Ovaj prikaz bolesnika ističe značaj rane dijagnoze, opisuje operativne tehnike korišćene u oporavku hronične RPT, kao i lečenje ranih postoperativnih komplikacija kao što je ruptura kontralateralnog ligamenta patele.
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