Introduction:

Simultaneous lesions of the patellar tendon (TP), anterior cruciate ligament (ACL) and the medial collateral ligament (MCL) are rare, and they are related to high-energy mechanisms, generally associated with chondral lesions, meniscal tears or bone fractures. The objective of this study is to present a clinical case, the surgical approach in two steps, and to provide other management options.

Case report:

We discuss the diagnostic strategy in a 42-year-old male with a high-energy trauma, the surgical technique and the clinical outcome. The case was solved in two surgical steps. First, a reconstruction of the TP, reinforcement with en allograft and reinsertion of the LCM with anchors were performed. Then, eight weeks later, the surgery consisted of an ACL reconstruction and meniscal repair by arthroscopy.

Discussion:

The patient’s age was above the average (29.9 years) of the reported case series. The mechanism of injury did not correspond to a sports-related event (77.41% in athletes). In contrast with the current literature, in this case we present a lesion of the TP associated with an LCM injury (67.74%), which has been reported previously as rare. We opted for a treatment in two steps according to the complexity of the lesions.