Minimal Incision Quadriceps Tendon Repair is a technique that reattaches a torn quadriceps tendon to the patella through a smaller incision than conventional open repair. The technique reduces wound size and soft-tissue disruption while maintaining the strong fixation required for early protected motion. Dr. Chudik performs this technique as part of his minimally invasive tendon repair work.
What Is Minimal Incision Quadriceps Tendon Repair?
The quadriceps tendon connects the quadriceps muscle to the top of the patella and is part of the extensor mechanism that straightens the knee. Complete tears typically occur at the tendon’s attachment to the superior pole of the patella and produce loss of active knee extension.
Conventional open quadriceps tendon repair requires a 6 to 10 cm incision over the front of the knee to expose the torn tendon and the patella for fixation. The minimal incision technique uses a 3 to 4 cm incision with longitudinal tendon-passing instruments that allow the same anchor or bone-tunnel fixation through a smaller approach.
The smaller incision reduces:
- Wound complication risk
- Subcutaneous tissue disruption
- Post-operative scar burden
- Skin healing time
Who Is a Candidate?
Candidates typically have:
- A complete quadriceps tendon rupture documented on examination (loss of active extension) and MRI
- Suitable anatomy for the minimal incision approach
- Acute injury (within four weeks)
- Active patient with functional concerns
- A medical profile that allows safe surgery
Patients with chronic retracted tears, significant tendon degeneration requiring tissue augmentation, or anatomy that does not allow the minimal incision approach may need conventional open repair.
How the Procedure Is Performed
The procedure is performed as outpatient surgery under regional anesthesia with sedation. A 3 to 4 cm transverse or longitudinal incision is made over the superior pole of the patella.
The torn quadriceps tendon is identified and freed from the surrounding tissue. The superior pole of the patella is prepared as the fixation site. Suture anchors or bone tunnels are placed through the small incision using specialized tendon-passing instruments. Strong locking sutures (Krackow or Bunnell pattern) are placed in the tendon and secured to the patella.
The retinaculum (the soft-tissue envelope around the tendon) is repaired if torn. Active extension is tested before closing.
For chronic tears with significant retraction, conventional open exposure is typically required to mobilize the tendon and may include allograft augmentation.
Recovery and Rehabilitation
Recovery follows the same protected protocol as conventional quadriceps repair, with the smaller incision improving soft-tissue recovery:
- Brace immobilization in extension for four to six weeks
- Passive range of motion within safe limits beginning early
- Progressive active extension from four to six weeks
- Strengthening from three months
- Return to most activity at three to four months
- Return to sport at six to nine months
Risks and Outcomes
Risks include re-rupture, persistent extensor lag, stiffness, hardware irritation, and infection. The minimal incision approach reduces wound complication risk compared with conventional open repair. Outcomes after acute minimal-incision repair are comparable to acute open repair.
Why Dr. Chudik for Minimal Incision Quadriceps Tendon Repair
Dr. Chudik performs minimally invasive tendon repair across the upper and lower extremity, including this minimal incision approach to acute quadriceps repair. The smaller incision aligns with his broader development work in less invasive tendon and ligament procedures.