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Published in: Archives of Orthopaedic and Trauma Surgery 3/2009

01-03-2009 | Arthroscopy and Sports Medicine

Patellar tendon ruptures in weight lifters after local steroid injections

Authors: Shen-Kai Chen, Cheng-Chang Lu, Pei-His Chou, Lan-Yuen Guo, Wen-Lan Wu

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 3/2009

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Abstract

Introduction

Weight lifting is commonly associated with an increase in knee injury risk. Local steroid injection is thought to be associated with increased risk of spontaneous tendon rupture. The purpose of this report is to describe incidence of rupture of the patellar tendon after receiving multiple local steroid injections in weight lifters.

Materials and methods

Seven weight lifters presented at the hospital with ruptured patellar tendon. All the patients had a history of multiple local steroid injections into the patellar tendon. Each patient received surgical treatment within 72 h after injury.

Results

After an average follow-up time of 26 months, the mean postoperative Lysholm knee score was 94 and the mean Insall-Salvati measurement was 0.96. All seven athletes returned to weight lifting training at 1 year after the operation. They returned to full competition at 18 months after the surgery.

Conclusion

For physicians who treat patellar tendonitis, especially in weight lifters, it is important to recognize the contributing factors for tendon rupture especially in those who have had multiple steroid injections. The functional prognosis of the knee improves if the normal length and strength of the injured tendon have been properly restored.
Literature
1.
go back to reference Balasubramaniam P, Prathap K (1972) The effect of injection of hydrocortisone into rabbit calcaneal tendons. J Bone Joint Surg Br 54:729–734PubMed Balasubramaniam P, Prathap K (1972) The effect of injection of hydrocortisone into rabbit calcaneal tendons. J Bone Joint Surg Br 54:729–734PubMed
2.
go back to reference Bickel KD (1996) Flexor pollicis longus tendon rupture after corticosteroid injection. J Hand Surg Am 21:152–153PubMedCrossRef Bickel KD (1996) Flexor pollicis longus tendon rupture after corticosteroid injection. J Hand Surg Am 21:152–153PubMedCrossRef
3.
go back to reference Bjorkman A, Jorgsholm P (2004) Rupture of the extensor pollicis longus tendon: a study of aetiological factors. Scand J Plast Reconstr Surg Hand Surg 38:32–35PubMedCrossRef Bjorkman A, Jorgsholm P (2004) Rupture of the extensor pollicis longus tendon: a study of aetiological factors. Scand J Plast Reconstr Surg Hand Surg 38:32–35PubMedCrossRef
4.
go back to reference Bonamo JJ, Krinick RM, Sporn AA (1984) Rupture of the patellar ligament after use of its central third for anterior cruciate ligament reconstruction. A report of two cases. J Bone Joint Surg Am 66:1294–1297PubMed Bonamo JJ, Krinick RM, Sporn AA (1984) Rupture of the patellar ligament after use of its central third for anterior cruciate ligament reconstruction. A report of two cases. J Bone Joint Surg Am 66:1294–1297PubMed
5.
go back to reference Carson WG Jr (1985) Diagnosis of extensor mechanism disorders. Clin Sports Med 4:231–246PubMed Carson WG Jr (1985) Diagnosis of extensor mechanism disorders. Clin Sports Med 4:231–246PubMed
6.
go back to reference Fredberg U (1997) Local corticosteroid injection in sport: review of literature and guidelines for treatment. Scand J Med Sci Sports 7:131–139PubMed Fredberg U (1997) Local corticosteroid injection in sport: review of literature and guidelines for treatment. Scand J Med Sci Sports 7:131–139PubMed
7.
go back to reference Giblin P, Small A, Nichol R (1982) Bilateral rupture of the ligamentum patellae: two case reports and a review of the literature. Aust N Z J Surg 52:145–148PubMedCrossRef Giblin P, Small A, Nichol R (1982) Bilateral rupture of the ligamentum patellae: two case reports and a review of the literature. Aust N Z J Surg 52:145–148PubMedCrossRef
8.
go back to reference Insall J, Salvati E (1971) Patella position in the normal knee joint. Radiology 101:101–104PubMed Insall J, Salvati E (1971) Patella position in the normal knee joint. Radiology 101:101–104PubMed
9.
go back to reference Karlsson J, Lundin O, Lossing IW, Peterson L (1991) Partial rupture of the patellar ligament—results after operative treatment. Am J Sports Med 19:403–408PubMedCrossRef Karlsson J, Lundin O, Lossing IW, Peterson L (1991) Partial rupture of the patellar ligament—results after operative treatment. Am J Sports Med 19:403–408PubMedCrossRef
10.
go back to reference Karpman RR, McComb JE, Volz RG (1980) Tendon rupture following local steroid injection: report of four cases. Postgrad Med 68:169–174PubMed Karpman RR, McComb JE, Volz RG (1980) Tendon rupture following local steroid injection: report of four cases. Postgrad Med 68:169–174PubMed
11.
go back to reference Kelly DW, Carter VW, Jobe FW, Kerlan RK (1984) Patellar and quadriceps tendon ruptures—jumper’s knee. Am J Sports Med 12:375–374PubMedCrossRef Kelly DW, Carter VW, Jobe FW, Kerlan RK (1984) Patellar and quadriceps tendon ruptures—jumper’s knee. Am J Sports Med 12:375–374PubMedCrossRef
12.
go back to reference Lindy PB, Boynton MB, Fadale PD (1994) Repair of patellar tendon disruptions without hardware. J Orthop Trauma 9:238–243CrossRef Lindy PB, Boynton MB, Fadale PD (1994) Repair of patellar tendon disruptions without hardware. J Orthop Trauma 9:238–243CrossRef
13.
go back to reference Linke E (1975) Achilles tendon ruptures following direct cortisone injection. Hefte Unfallheilkd 121:302–303PubMed Linke E (1975) Achilles tendon ruptures following direct cortisone injection. Hefte Unfallheilkd 121:302–303PubMed
14.
go back to reference Lysholm J, Gillquist J (1982) Evaluation of knee ligament surgery results with special emphasis on use of a scoring scale. Am J Sports Med 10:150–154PubMedCrossRef Lysholm J, Gillquist J (1982) Evaluation of knee ligament surgery results with special emphasis on use of a scoring scale. Am J Sports Med 10:150–154PubMedCrossRef
15.
go back to reference Mackie JW, Goldin B, Foss ML, Cockrell JL (1974) Mechanical properties of rabbit tendons after repeated anti-inflammatory steroid injections. Med Sci Sports 6:198–202PubMed Mackie JW, Goldin B, Foss ML, Cockrell JL (1974) Mechanical properties of rabbit tendons after repeated anti-inflammatory steroid injections. Med Sci Sports 6:198–202PubMed
16.
go back to reference Meier JO (1990) Rupture of biceps tendon after injection of steroid. Ugeskr Laeger 152:3258PubMed Meier JO (1990) Rupture of biceps tendon after injection of steroid. Ugeskr Laeger 152:3258PubMed
17.
go back to reference Michna H (1988) Appearance and ultrastructure of intranuclear crystalloids in tendon fibroblasts induced by an anabolic steroid hormone in the mouse. Acta Anat 133:247–250PubMedCrossRef Michna H (1988) Appearance and ultrastructure of intranuclear crystalloids in tendon fibroblasts induced by an anabolic steroid hormone in the mouse. Acta Anat 133:247–250PubMedCrossRef
18.
go back to reference Michna H (1987) Tendon injuries induced by exercise and anabolic steroids in experimental mice. Int Orthop 11:157–162PubMedCrossRef Michna H (1987) Tendon injuries induced by exercise and anabolic steroids in experimental mice. Int Orthop 11:157–162PubMedCrossRef
19.
go back to reference Paavola M, Kannus P, Jarvinen TA, Jarvinen TL, Jozsa L, Jarvinen M (2002) Treatment of tendon disorders. Is there a role for corticosteroid injection? Foot Ankle Clin 7:501–513PubMedCrossRef Paavola M, Kannus P, Jarvinen TA, Jarvinen TL, Jozsa L, Jarvinen M (2002) Treatment of tendon disorders. Is there a role for corticosteroid injection? Foot Ankle Clin 7:501–513PubMedCrossRef
20.
go back to reference Phelps D, Sonstegard DA, Matthews LS (1974) Corticosteroid injection effects on the biomechanical properties of rabbit patellar tendons. Clin Orthop Relat Res 100:345–348PubMedCrossRef Phelps D, Sonstegard DA, Matthews LS (1974) Corticosteroid injection effects on the biomechanical properties of rabbit patellar tendons. Clin Orthop Relat Res 100:345–348PubMedCrossRef
21.
go back to reference Risser WL (1990) Musculoskeletal injuries caused by weight training. Guidelines for prevention. Clin Pediatr 29:305–310CrossRef Risser WL (1990) Musculoskeletal injuries caused by weight training. Guidelines for prevention. Clin Pediatr 29:305–310CrossRef
22.
go back to reference Risser WL, Risser JM, Preston D (1990) Weight-training injuries in adolescents. Am J Dis Child 144:1015–1017PubMed Risser WL, Risser JM, Preston D (1990) Weight-training injuries in adolescents. Am J Dis Child 144:1015–1017PubMed
23.
go back to reference Rosenberg JM, Whitaker JH (1991) Bilateral infrapatellar tendon rupture in a patient with jumpers knee. Am J Sports Med 19:94–95PubMedCrossRef Rosenberg JM, Whitaker JH (1991) Bilateral infrapatellar tendon rupture in a patient with jumpers knee. Am J Sports Med 19:94–95PubMedCrossRef
24.
go back to reference Scutt N, Rolf CG, Scutt A (2006) Glucocorticoids inhibit tenocyte proliferation and Tendon progenitor cell recruitment. J Orthop Res 24:173–182PubMedCrossRef Scutt N, Rolf CG, Scutt A (2006) Glucocorticoids inhibit tenocyte proliferation and Tendon progenitor cell recruitment. J Orthop Res 24:173–182PubMedCrossRef
25.
go back to reference Siwek CW, Rao JU (1981) Ruptures of the extensor mechanism of the knee joint. J Bone Joint Surg Am 64:932–937 Siwek CW, Rao JU (1981) Ruptures of the extensor mechanism of the knee joint. J Bone Joint Surg Am 64:932–937
26.
go back to reference Sochart DH, Shravat BP (1994) Bilateral patellar tendon disruption—a professional predisposition? J Accid Emerg Med 11:255–256PubMed Sochart DH, Shravat BP (1994) Bilateral patellar tendon disruption—a professional predisposition? J Accid Emerg Med 11:255–256PubMed
27.
go back to reference Sweetnam R (1969) Corticosteroid arthropathy and tendon rupture. J Bone Joint Surg Br 51:397–398PubMed Sweetnam R (1969) Corticosteroid arthropathy and tendon rupture. J Bone Joint Surg Br 51:397–398PubMed
28.
go back to reference Tsai WC, Tang FT, Wong MK, Pang JH (2003) Inhibition of tendon cell migration by dexamethasone is correlated with reduced alpha-smooth muscle actin gene expression: a potential mechanism of delayed tendon healing. J Orthop Res 21:265–271PubMedCrossRef Tsai WC, Tang FT, Wong MK, Pang JH (2003) Inhibition of tendon cell migration by dexamethasone is correlated with reduced alpha-smooth muscle actin gene expression: a potential mechanism of delayed tendon healing. J Orthop Res 21:265–271PubMedCrossRef
29.
go back to reference Unverferth LJ, Olix ML (1973) The effect of local steroid injections on tendon. J Sports Med 1:31–37PubMedCrossRef Unverferth LJ, Olix ML (1973) The effect of local steroid injections on tendon. J Sports Med 1:31–37PubMedCrossRef
30.
go back to reference Webb LX, Toby EB (1986) Bilateral rupture of the patellar tendon in an otherwise healthy male patient following minor trauma. J Trauma 26:1045–1048PubMedCrossRef Webb LX, Toby EB (1986) Bilateral rupture of the patellar tendon in an otherwise healthy male patient following minor trauma. J Trauma 26:1045–1048PubMedCrossRef
31.
go back to reference Wong MW, Tang YN, Fu SC, Lee KM, Chan KM (2004) Triamcinolone suppresses human tenocyte cellular activity and collagen synthesis. Clin Orthop Relat Res 421:277–281PubMedCrossRef Wong MW, Tang YN, Fu SC, Lee KM, Chan KM (2004) Triamcinolone suppresses human tenocyte cellular activity and collagen synthesis. Clin Orthop Relat Res 421:277–281PubMedCrossRef
Metadata
Title
Patellar tendon ruptures in weight lifters after local steroid injections
Authors
Shen-Kai Chen
Cheng-Chang Lu
Pei-His Chou
Lan-Yuen Guo
Wen-Lan Wu
Publication date
01-03-2009
Publisher
Springer-Verlag
Published in
Archives of Orthopaedic and Trauma Surgery / Issue 3/2009
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-008-0655-1

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