Case of Chronic Neglected Patellar Tendon Rupture Reconstruction Using Semitendinosus and Gracilis Tendon Autologous Graft

Introduction: Patellar tendon rupture is an uncommon injury that may progress to a chronic or neglected state when initial diagnosis and treatment are delayed. Case Report: We report the case of a 17-year-old male who sustained a cut-laceration injury over the right knee that was sutured primarily elsewhere, following which he developed progressive instability and inability to actively extend the knee. Imaging revealed patella alta with a complete patellar tendon rupture. The patient underwent reconstruction using a modified Ecker's technique with semitendinosus and gracilis autografts passed through single tibial and patellar tunnels in figure-of-eight and figure-of-seven configurations, respectively, to restore the extensor mechanism. Post-operative rehabilitation involved staged mobilization with a hinged knee brace and progressive range-of-motion exercises. At 1-year follow-up, the patient had regained functional knee flexion, returned to daily activities, and demonstrated only minimal residual extension lag. Conclusion: This case highlights the effectiveness of hamstring autograft reconstruction using a biologic tension-band-like configuration for chronic neglected patellar tendon ruptures, allowing stable fixation, early rehabilitation, and satisfactory functional recovery.