Revision quadriceps tendon repair: A case series and technique guide to a novel repair
Abstract
Introduction Revision quadriceps tendon repair is a challenging problem. In this four-case series, novel quadriceps tendon revision resulted in improved range of motion and durable repair for patients with recurrent rupture. Methods Our technique includes a combination of a running locked #5 FiberWire or 2 mm SutureTape suture placed through parallel medial, lateral, and central drill holes in the patella with running Krackow-type quadriceps tendon repair medially and laterally resulting in four strands, delivering the vastus medialis and medial quadriceps tendon to an anatomic repair at the superior pole of the patella, with 2 sutures passed centrally and 1 each passed medially and laterally and then tied. Reinforcement is performed using a tibialis anterior tendon allograft with placement at the inferior pole of the patella starting superolaterally coursing lateral to medial through infrapatellar tendon. It is then threaded medially into the centrally repaired portion of the quadriceps tendon, and then back down to the lateral suprapatellar and lateral patellar retinaculum, giving three crossing strands. This is repaired with multiple interrupted 0 Vicryl mattress sutures. Immobilization postoperatively was dictated by patient's body habitus. Results Patient 1 was a 79-year-old obese man treated after two prior revision periprosthetic quadriceps repair procedures. He was immobilized in a knee immobilizer for 8 weeks postoperatively. He was revised for TKA instability at 6…
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Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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