Dataset Information

Chronic Quadriceps Tendon Ruptures: Primary Repair of Quadriceps Via Bioaugmentation and Patellar Tendon Lengthening.

ABSTRACT: Quadriceps tendon ruptures are devastating injuries that impair the extensor mechanism of the knee. Complete tears require prompt surgical intervention in order to ensure optimal clinical outcomes. Chronic, neglected ruptures- marked by severe extensor lag, muscular atrophy, and tendon retraction- are difficult to treat. Further, severe patella baja complicates surgical planning. While there is no consensus on optimal treatment for these injuries, many different techniques have been proposed. Unlike many of these approaches, our technique focuses on restoration of patellar height via patellar tendon lengthening. Once patellar height is restored, quadriceps tendon repair can be performed using the native quadriceps tendon. Both the patellar tendon lengthening and the quadriceps tendon repair are augmented with bioinductive implants to ensure optimal healing environments, enabling us to reestablish native extensor mechanism function.

SUBMITTER: Watson SL

PROVIDER: S-EPMC9353194 | biostudies-literature | 2022 Jul

REPOSITORIES: biostudies-literature

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Publications

Chronic Quadriceps Tendon Ruptures: Primary Repair of Quadriceps Via Bioaugmentation and Patellar Tendon Lengthening.

Watson Samantha L SL Kingham Yasemin E YE Patel Ronak M RM

Arthroscopy techniques 20220614 7

Quadriceps tendon ruptures are devastating injuries that impair the extensor mechanism of the knee. Complete tears require prompt surgical intervention in order to ensure optimal clinical outcomes. Chronic, neglected ruptures- marked by severe extensor lag, muscular atrophy, and tendon retraction- are difficult to treat. Further, severe patella baja complicates surgical planning. While there is no consensus on optimal treatment for these injuries, many different techniques have been proposed. Un ...[more]

PMID: 35936866

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Project description:In the setting of traumatic midsubstance patellar tendon ruptures in which the tissue is unable to be repaired end to end, surgical options are limited. We offer a technique using suture anchors for the native tendon reconstruction, allograft augmentation, and a bioinductive implant. Technique Video Video 1 Introduction (0-7 seconds). Author disclosures (8-12 seconds). With the patient in the supine position on the operating room table, a midline incision is made over the patellar tendon (13-41 seconds). The patellar tendon tissue must be examined to determine how the surgeon can repair it. As shown, the surgeon identifies the midsubstance tear and the proximal and distal remnants of the tissue. Two No. 5 FiberWires are placed in a running locking fashion in the proximal tissue fibers (42 seconds to 1 minute 7 seconds). These FiberWire sutures will be anchored into the proximal tibia. The surgeon slides the allograft tendon through the tunnel just created in the tibial tubercle (1 minute 8 seconds to 1 minute 37 seconds). Both the allograft limbs are brought up along the medial and lateral side of the patellar tendon. By use of a tonsil clamp, the graft is passed below the retinacular layer to the superior pole of the patella (1 minute 38 seconds to 1 minute 46 seconds). The allograft is slid under the retinacular layer and will exit at the superior pole of the patella. With the knee flexed to 30°, the allograft is tensioned down and 3 No. 5 FiberWire sutures are placed in a figure-of-8 fashion to help approximate the 2 graft ends (1 minute 47 seconds to 2 minutes 2 seconds). This step is critical because the augmentation protects the tendon repair. The surgeon should ensure that the allograft is secured. In preparation for the distal tendon tissue to be anchored into the inferior pole of the patella, 2 guide pins are placed in the inferior pole of the patella, separated by 20 mm (2 minutes 3 seconds to 3 minutes 6 seconds). The surgeon then reams over those guide pins, and the distal tendon tissue will be anchored in. The proximal patellar tendon leaflet is anchored in distally on the proximal tibia (3 minutes 7 seconds to 3 minutes 28 seconds). The proximal tendon is overlapping the distal tendon leaflet that is anchored into the inferior pole of the patella. The allograft augmentation is on the medial and lateral aspects of the tendon and is under the retinacular layer and is tied at the superior pole of the patella. The graft is placed over the midportion of the patellar tendon and sutured in with interrupted No. 1 Vicryl (3 minutes 29 seconds to 3 minutes 39 seconds).

Dataset Information

Chronic Quadriceps Tendon Ruptures: Primary Repair of Quadriceps Via Bioaugmentation and Patellar Tendon Lengthening.

Publications

Chronic Quadriceps Tendon Ruptures: Primary Repair of Quadriceps Via Bioaugmentation and Patellar Tendon Lengthening.

Similar Datasets

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