Quadriceps Tendon Rupture

Austin Fares, MD

Content Contributor

Evolution of Technology

Quadriceps Tendon Repair

Suture anchor repair has demonstrated to be a viable option for treating quadriceps tendon ruptures. These suture anchor-based repairs have the strength equivalent to bone tunnel repairs and avoids the potential complication of postoperative fracture. Likewise, the anchors can be placed through a smaller incision than using tunnels. Thick, tough sutures can be used to improve the strength of the suture-tendon interface, and lead to a stronger repair construct than surgeon-tied knots. Additional minimally invasive techniques have been used to help decrease post-operative pain and give a more cosmetically appealing result.

Evolution of Procedure

Quadriceps Tendon Surgery

A quadriceps tendon repair involves reattaching the tendon to its native insertion on the patella (kneecap). There are a number of techniques that allow for successful repair. One of oldest repair techniques is to sew thick sutures into the torn tendon and pass them through bone tunnels in the patella. Newer techniques include using suture anchors which can be screwed into the kneecap and sewn into the damaged tendon to facilitate repair. Classically, large incisions are used for repairs which portends an increased risk for wound-healing complications, infection, and scarring.

Evolution of Diagnosis

Quadriceps Tendon Rupture

Tears in the quadriceps tendon are rare, but potentially devastating injuries. The quadriceps tendon is the confluence of the four thigh muscles located just above the patella (kneecap). The function of the quadriceps tendon is to help extend the leg, which is critical for basic everyday tasks to include walking and sitting. Injury to the tendon typically occurs in males >40 years old and may be the result of a sports injury, trauma, or chronic degenerative changes. Nonsurgical management is uncommon and primarily limited to those with partial tears or those who are too unhealthy to safely perform surgery. The vast majority of quadriceps tendon tears are treated surgically by reattaching the torn tendon to the top of the kneecap. Typically, early repair is necessary to prevent the tendon from retracting and scarring in a shortened position.

Technology Spotlight

Arthrex Quad Tendon Repair with PARS (Percutaneous Achilles Repair System) Technique

The Arthrex Percutaneous Achilles Repair System (PARS) is used for a wide assortment of tendon injuries to include quadriceps, patella, and achilles tendon ruptures. The minimally invasive PARS system helps facilitate consistently reliable capture of the quadriceps tendon and without the need for large incisions, which are associated with a higher risk of complications and scarring.

The anatomically contoured guide can be re-used, while the suture and passing needles come packaged in a convenient kit. The kit has a locking option allowing the surgeon to incorporate a locked FiberWire suture on both ends of the ruptured tendon. This results in a stronger repair than just passing transverse sutures across the tendon like other minimally invasive devices on the market. Finally, the PARS system allows the healed tendon to achieve a more natural contour, unlike the typical hypertrophic tendon resulting from open repair.