# Neglected Patellar Tendon Rupture Treated With a Single Semitendinosus Tendon in One-Stage Reconstruction Surgery: A Case Report of an Unusual Injury Mechanism

## TL;DR

A patient with a patellar tendon rupture from a gunshot wound was successfully treated with a one-stage tendon reconstruction using the semitendinosus tendon.

## Contribution

This case report presents a novel one-stage reconstruction technique using a single semitendinosus tendon for patellar tendon rupture.

## Key findings

- The patient achieved full range of motion and pain-free walking after one year.
- MRI showed near-normal patellar alignment in the injured leg compared to the uninjured leg.

## Abstract

We present the case of a 23-year-old patient who sustained a gunshot wound (GSW) during a mass shooting and had an unrecognized rupture of the patellar tendon. The patient was treated with a single-stage reconstruction, using only the semitendinosus tendon with preserved distal tendon insertion and two tunnels, transtibial and trans patellar, along with McLaughlin augmentation of the repair. The reconstruction proved strong enough to withstand the postoperative rehabilitation process. At the one-year follow-up, the patient walked without pain, had a full range of motion, and had enough muscle strength in the upper leg. The MRI showed the injured leg had almost the same Insall-Salvati ratio and Caton-Deschamps index as the uninjured leg.