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Steven Malvasi, Brian Gloyeske, Matthew Johnson and Timothy Miller

Background:

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.

Methods:

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.

Results:

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.

Conclusion:

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.