Patellar and Quadriceps Tendon Repair
The patellar and quadriceps tendons are important structures that connect the kneecap (patella) and the thigh muscles (quadriceps) to the shin bone (tibia). These tendons are responsible for transmitting the forces generated by the thigh muscles to the lower leg bones, enabling movement and stability of the knee joint. A serious rupture of either tendon can cause functional impairment.
The primary treatment for a complete tendon rupture is surgery due to the need to restore knee function and avoid the increased risk of disability. Early surgery is important to avoid shrinkage of the tendon which increases the need for augmentation with graft tissue.
The surgical repair of patellar and quadriceps tendon ruptures is typically reserved for patients with complete tendon tears or significant functional impairment. Partial tears or mild symptoms may be managed conservatively with rest, immobilization, physical therapy, and non-steroidal anti-inflammatory drugs (NSAIDs). However, in cases of complete tears or severe functional limitation, surgical intervention is usually necessary to restore the normal function of the knee joint.
The surgical repair of patellar and quadriceps tendon ruptures is a complex procedure that requires careful planning and execution. There are different surgical techniques that can be used for patellar and quadriceps tendon repair, such as the traditional open technique or minimally invasive arthroscopic technique. The specific technique used may depend on factors including the location, extent, and chronicity of the tendon tear, as well as the age, activity level, and comorbidities of the patient.
The surgical repair of a patellar or quadriceps tendon rupture typically involves reattaching the tendon to the bone using sutures and anchors using strong, non-absorbable sutures.
When the tendon is degenerated or severely damaged and the time to surgery has been delayed, the procedure is tendon reconstruction with a graft of tissue from another part of the body to replace the damaged portion of the tendon. They may use an allograft (donor tissue) or autograft (tissue from another part of the patient’s body) to reinforce the repair and promote healing. The patient will need to wear a cast or brace for several weeks after surgery and undergo physical therapy to regain strength and mobility in the knee.
The outcomes of surgical repair of patellar and quadriceps tendon ruptures are generally good, with most patients experiencing significant improvement in pain, function, and quality of life. However, the success of the surgery depends on several factors, including the extent and chronicity of the tendon tear, the patient’s age and comorbidities, and the rehabilitation program. Patients who undergo timely surgery, have complete tendon tears, and comply with the rehabilitation program usually achieve good outcomes.
Complications from patellar tendon tears are relatively rare but can include infection, nerve damage, or failure of the repair or graft to properly heal. Re-rupture is rare.
In the immediate postoperative period, the patient may need to use crutches or a brace to protect the repair site and limit weight-bearing on the affected leg. Pain and swelling are common after surgery and can be managed with pain medications and ice therapy. The patient will typically begin physical therapy soon after surgery to promote healing, restore range of motion, and prevent complications such as stiffness. The rehabilitation program typically last for several months.
The recovery time after patellar or quadriceps tendon repair surgery can vary depending on various factors, such as the extent and chronicity of the tendon tear, the surgical technique used, the patient’s age and activity level, and the rehabilitation program. Generally, patients can expect to spend several weeks to several months in recovery after surgery. Return to sports or other high-impact activities may take longer and will depend on several factors such as the patient’s healing progress, functional recovery, and ability to tolerate impact forces.
Patellar and quadriceps tendon ruptures are serious injuries that can significantly impact the function and quality of life of affected individuals. Surgical repair of these tendons is usually necessary in cases of complete tears or severe functional impairment and involves reattaching the tendon to the bone using sutures and anchors.
Dr. Ajay C. Lall is a former dual sport NCAA collegiate athlete (football and track & field), American board certified, triple fellowship-trained expert orthopedic surgeon who specializes in diagnosing and treating knee injuries. He treats non-athletes and athletes at all levels of play from collegiate to professional to the Olympic level. Dr. Lall is a world-renowned orthopedic surgeon who cares for all patients like family. Contact LALL Orthopedics + to schedule a consultation, receive the correct diagnosis, and undergo state-of-the-art treatment options.
At a Glance
Ajay C. Lall, MD, MS, FAAOS
- Board Certified – Orthopedic Surgery
- Triple Fellowship Trained
- Performs over 750 Surgeries Per Year
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