Multi-Ligamentous Knee Injury in Sports Involving Concomitant Anterior Cruciate Ligament and Patellar Tendon Disruption: A Review of Case Reports

in International Journal of Athletic Therapy and Training
Steven Malvasi BS, ATC 1 , Brian Gloyeske MS, ATC 2 , Matthew Johnson PT, DPT, OCS 2 , and Timothy Miller PT, DPT, OCS, SCS, CSCS 2
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  • 1 Keller Army Community Hospital
  • 2 St. Luke’s University Health Network
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Injury to the anterior cruciate ligament (ACL) is one of the most common orthopedic injuries in the United States, while injury to the patellar tendon (PT) is less common. A combined rupture to the ACL and PT is consequentially uncommon and increases the difficulty of a correct initial diagnosis. The purpose of this paper is to critically appraise the current peer-reviewed literature regarding multi-ligamentous knee injuries (MLKI) in sport.


A systematic review was undertaken to identify all relevant peer-reviewed articles regarding MLKI from March 1980 to January 2015. All articles pertaining to simultaneous rupture of the ACL and PT were included for review.


A total of 27 cases presented in 15 articles were used. Findings suggest that the combination of a palpable gap over the PT, a positive Lachman test, inability to complete terminal knee extension, and a superior position of the patella are clinical examination markers for a possible MLKI involving the ACL and PT.


Simultaneous rupture to the ACL and PT is incredibly rare within the sport population, making diagnosis and treatment of such injury challenging. A thorough examination of the extensor mechanism of the knee is important in making the proper diagnosis.