Quadriceps reconstruction with suture anchor and Achilles allograft combination in quadriceps tendon re-rupture after primary surgical repair: A novel technique

Abstract

Quadriceps ruptures are one of the pathological conditions of the knee extensor mechanism, accounting for 3% of all tendon injuries. These injuries cause substantial disability of the extensor mechanism. Primary repair is the treatment of choice in acute presentation. In the setting of chronic conditions, the treatment becomes more challenging. Available surgical options include lengthening procedures, and reconstruction with auto graft or allografts. The traditional Scuderi and Codivilla techniques are challenging to perform in degenerative or traumatic retracted ruptures. There is no standard effective treatment in these patients, which yields the best clinical and biomechanical outcomes. An 18 - year-old male patient with quadriceps re-rupture after a primary repair was managed with allograft reconstruction using suture anchors. At six years of follow-up, the patient gained a full range of motion with excellent clinical outcomes. He returned to his previous work. In conclusion, quadriceps reconstruction using suture anchor and Achilles allograft combination is a feasible technique in neglected cases who present with quadriceps tendon re-rupture after primary surgical repair.

Quadriceps Tendon Reconstruction With Achilles Tendon Bone Block Allograft

“…Okay et al. 11 report QT reconstruction with Achilles tendon allograft and suture anchors into the superior aspect of the patella in a case that previously failed primary repair. This case demonstrated a satisfactory outcome and graft incorporation at the 6-year follow-up.…”

Left Knee Open Rectus Femoris Repair With Achilles Allograft Augmentation

“…A utograft or allograft reconstruction of QT ruptures should be considered when native tissue quality is poor or in the setting of larger defects not amenable to primary repair or repair with lengthening techniques 8 . Owing to the paucity of QT ruptures that cannot be repaired with primary reconstruction or V-Y lengthening, the literature on Achilles tendon allograft for the treatment of subacute and chronic QTruptures is limited to 5 prior reports 8,[15][16][17][18] .…”

“…Outcomes studying repair of subacute and chronic QT ruptures using autograft or allograft reconstruction have been rarely characterized because of a paucity of these injuries that cannot be treated with primary repair or tendon lengthening. Data on the use of Achilles tendon allograft reconstruction for the treatment of subacute and chronic QT ruptures is especially limited 8,[15][16][17][18] . We present an unusual presentation of a subacute tendon tear isolated to the rectus femoris tendon and a reconstruction technique using an Achilles tendon allograft.…”

Spontaneous bilateral quadriceps tendon rupture treated with polyethylene terephthalate tape augmentation: Report of two consecutive cases

“…Spontaneous rupture of QT is rare and it is commonly associated with systemic comorbidities, leading to tendon degeneration such as connective tissue disorders, chronic renal failure, rheumatoid arthritis, diabetes, hyperparathyroidism, gout and pharmacological treatments with fluoroquinolones and steroids. [ 1 ] While unilateral rupture is a relatively common injury and it has been well reported,[ 2 ] spontaneous bilateral ruptures are very rare, and literature provides only few reports, in almost all cases treated with direct repair or autograft augmentation. [ 3 ]…”

“…Spontaneous rupture of QT is rare and it is commonly associated with systemic comorbidities, leading to tendon degeneration such as connective tissue disorders, chronic renal failure, rheumatoid arthritis, diabetes, hyperparathyroidism, gout and pharmacological treatments with fluoroquinolones and steroids. [1] While unilateral rupture is a Spontaneous rupture of quadriceps tendon (QT) is a rare condition and it is commonly associated with systemic comorbidities and medical products assumption, which may lead to tendon degeneration. While unilateral rupture is a quite common injury, spontaneous bilateral ruptures are very rare.…”