Patellar and Quadriceps Tendon Tears: Patellar Tendon Repair

Patellar and Quadriceps Tendon Tears: Patellar Tendon Repair

This surgical video demonstrates a patellar tendon repair to treat a patellar tendon tear. This procedure will also use reinforcing sutures and a biologic skin graft to support the repair. Here, we see a right knee with the patellar tendon torn in the middle of the tendon. The outer side of the knee is on the left side of the screen, and the inner side of the knee is on the right side of the screen.

The surgeon has already made an incision along the front of the knee to expose the patellar tendon and patella, or kneecap. The surgeon begins by placing a clamp onto the top part of the torn tendon and using sutures to place stitches through both sides of the patellar tendon. The same steps are then repeated for the bottom part of the torn tendon.

Next, the surgeon moves underneath the tendon to insert anchors that contain sutures. The surgeon pulls up the top part of the torn tendon and uses a drill and a bone tap to create a hole into the bottom of the kneecap to insert an anchor. This anchor contains 2 sets of sutures: small repair sutures and flat reinforcing sutures. The same steps are repeated for a second anchor.

The surgeon then passes all of the sutures from the anchors through the top portion of the patellar tendon, so that the sutures will lay on top of the tendon. They are moved out of the way for now. Next, the surgeon ties together the sutures that were sewn through the tendon to bring the torn parts back together.

In this procedure, the surgeon places a biologic skin graft over the tendon. Biologic skin grafts can be used to support the repair when the tendon may not be strong enough to heal on its own. The surgeon passes the small repair sutures through the top edge of the graft and then will position the flat sutures to lay on top of the graft.

A hole is then drilled in the tibia, or shinbone. The surgeon then threads 1 strand from each of the anchors in the top of the knee into another anchor that is tapped in place into the shinbone. The surgeon repeats the same steps for the other side of the knee. Small sutures are then used to tack down the bottom corners of the skin graft.

The surgeon will finish by cutting off all the suture strands and using sutures to close the skin incision. The patellar tendon repair is now complete.