Augmented Repair of an Acute Midsubstance Patellar Tendon Rupture Using Suture Anchors, InternalBrace™, and Achilles Tendon Allograft: A Case Report

Patellar tendon (PT) ruptures are rare but disabling injuries that result in loss of active knee extension and significant functional impairment. We present the case of a 56-year-old male who sustained a complete midsubstance PT rupture after a direct blow to the knee. MRI confirmed the injury, and surgical management included end-to-end repair with suture anchors, augmentation with an InternalBrace™ (Arthrex Inc, Naples, USA), circumferential Achilles tendon allograft reinforcement, and repair of the medial and lateral patellofemoral capsule. Postoperative imaging confirmed restoration of patellar height, and early rehabilitation was initiated using a hinged knee brace. Augmented repair provided robust biomechanical stability, preserved patellar height, and allowed progressive early mobilization. Clinical outcomes for acute midsubstance PT ruptures demonstrate high rates of functional recovery and return to daily activities, sport, and work. Acute midsubstance PT ruptures can thus be effectively managed with combined repair and augmentation strategies, achieving excellent functional outcomes while enabling early rehabilitation.