{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T05:00:50Z","timestamp":1790830850177,"version":"4.1.0"},"reference-count":14,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"vor","delay-in-days":272,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Orthopedics"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Patellar tendon ruptures (PTRs) are critical causes of knee extensor mechanism failure. Although typically isolated, a split\u2010level bilaminar rupture pattern, in which different layers of the PTR at different anatomical levels, is extremely rare in adults, particularly when associated with complex multiligamentous injuries (occurring in only 0.02%\u20130.2% of orthopedic cases).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Presentation<\/jats:title>\n                    <jats:p>A 60\u2010year\u2010old female presented with acute knee pain and loss of active extension following a fall. Clinical examination revealed patella alta and a palpable infrapatellar gap. Imaging confirmed a full\u2010thickness PTR, a medial femoral condyle avulsion fracture (MCL attachment), and a fibular head fracture (PLC injury\u2010variant). Intraoperatively, a split\u2010level bilaminar PTR and a complete midsubstance ACL (anterior cruciate ligament) rupture were identified. The injury was managed through primary repair augmented with a peroneus longus tendon (PLT) autograft to provide early mechanical stability and protect secondary stabilizers during healing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>A split\u2010level bilaminar PTR in adults with concomitant multiligamentous injury is a rare clinical entity that requires high diagnostic suspicion. In this case, PLT augmentation provided a robust construct for extensor mechanism reconstruction while preserving the hamstring tendons and allowing good functional outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this case, anatomical repair augmented with a peroneus longus autograft resulted in restoration of the extensor mechanism at the 6\u2010month postoperative follow\u2010up while preserving the hamstring tendons.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/cro\/5640221","type":"journal-article","created":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T04:47:23Z","timestamp":1790830043000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Reconstruction of a Rare Split\u2010Level Bilaminar Patellar Tendon Rupture With Concomitant Multiligament Knee Injury Using Peroneus Longus Autograft: A Case Report"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6150-9300","authenticated-orcid":false,"given":"Hamit \u00c7a\u011flayan","family":"Kahraman","sequence":"first","affiliation":[{"name":"Department of Orthopedics and Traumatology Fatih Sultan Mehmet Training and Research Hospital  Istanbul T\u00fcrkiye  fsmhastanesi.gov.tr"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1229-9815","authenticated-orcid":false,"given":"Bekir Eray","family":"Kilinc","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology Fatih Sultan Mehmet Training and Research Hospital  Istanbul T\u00fcrkiye  fsmhastanesi.gov.tr"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,30]]},"reference":[{"key":"e_1_2_11_1_2","unstructured":"MabroukA.andSiwiecR. M. Patellar Tendon Rupture 2026 StatPearls Publishing StatPearls. Treasure Island (FL) https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK513275\/."},{"key":"e_1_2_11_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jajs.2018.08.003"},{"key":"e_1_2_11_3_2","doi-asserted-by":"publisher","DOI":"10.3928\/01477447-20150105-06"},{"key":"e_1_2_11_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-013-1696-7"},{"key":"e_1_2_11_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.asmr.2020.08.013"},{"key":"e_1_2_11_6_2","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.15.15795"},{"key":"e_1_2_11_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546519894333"},{"key":"e_1_2_11_8_2","doi-asserted-by":"publisher","DOI":"10.35366\/99141"},{"key":"e_1_2_11_9_2","doi-asserted-by":"publisher","DOI":"10.18203\/issn.2455-4510.IntJResOrthop20252661"},{"key":"e_1_2_11_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jajs.2018.08.002"},{"key":"e_1_2_11_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jisako.2023.07.001"},{"key":"e_1_2_11_12_2","doi-asserted-by":"publisher","DOI":"10.18019\/1028-4427-2022-27-6-789-794"},{"key":"e_1_2_11_13_2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.41052"},{"key":"e_1_2_11_14_2","doi-asserted-by":"publisher","DOI":"10.1177\/23259671211005090"}],"container-title":["Case Reports in Orthopedics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/cro\/5640221","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/cro\/5640221","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/cro\/5640221","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T04:47:42Z","timestamp":1790830062000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/cro\/5640221"}},"subtitle":[],"editor":[{"given":"Shashank","family":"Kaushik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":14,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1155\/cro\/5640221"],"URL":"https:\/\/doi.org\/10.1155\/cro\/5640221","archive":["Portico"],"relation":{},"ISSN":["2090-6749","2090-6757"],"issn-type":[{"value":"2090-6749","type":"print"},{"value":"2090-6757","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2026-04-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-22","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-30","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"5640221"}}