The quadriceps muscles on the front of the thigh attach to the patella (kneecap) by the quadriceps tendon. When the quadriceps tendon is injured, the quadriceps muscles and the patella are no longer properly connected and this results in loss of function of the quadriceps muscles. The quadriceps muscles work to straighten the knee or control the knee during bending or squatting. A complete rupture of the tendon leaves a patient unable to fully straighten the knee or walk normally without the knee giving out. The quadriceps tendon usually is torn by a sudden episode of stressful over-activity such as jumping or falling. Repairing the tendon back to the patella is recommended since the quadriceps tendon is needed to walk normally and perform other daily activities.
Contraindications
- Inability or unwillingness to complete the postoperative program or to perform the rehabilitation necessary to regain proper leg function
- Infection of the knee (current or previous; not an absolute contraindication)
Risks and Complications of Surgery
- Infection
- Swelling or continued pain of the knee
- Re-injury of the repair
- Knee stiffness (loss of knee motion) or muscle weakness
- Rarely, clot in the veins of the calf or thigh (deep venous thrombosis, phlebitis) that may break off in the bloodstream and go to the lungs (pulmonary embolus)
Hospitalization and Anesthesia
- Outpatient surgery (go home the same day)
- General anesthetic, femoral nerve block
General Surgical Technique
The goal of the surgery is to repair the torn quadriceps tendon back to the patella to restore normal knee mechanics. Dr. Chudik identifies the torn end of the tendon through a limited incision just over the knee cap. Once identified, he places strong sutures through the tendon in order to grasp it and reconnect it back to the patella. He drills three small tunnels through the patella, and passes the sutures from the tendon through the tunnels and ties them to reconnect the torn tendon. It is important to protect the repair by keeping the knee straight locked in a brace.