Patellar and Quadriceps Tendon Tears: Quadriceps Tendon Repair

Patellar and Quadriceps Tendon Tears: Quadriceps Tendon Repair

This cadaveric surgical video demonstrates a quadriceps tendon repair to treat a quadriceps tendon tear. Here, we see a right knee with the quadriceps tendon torn off from the patella, or kneecap. 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 quadriceps tendon and kneecap. The surgeon begins by drilling 2 tunnels through the kneecap. The drills are hollow, allowing the surgeon to pass a guidewire through each drill. The surgeon removes 1 drill and replaces the wire with a passing suture. The same steps are repeated for the second drill.

Next, the surgeon marks out 2 small slits into the patellar tendon at the bottom of the kneecap. This helps make room for the soft anchors that will be placed in the kneecap. Each anchor is already threaded with sutures. The surgeon uses the passing suture from 1 of the tunnels in the kneecap to pass sutures from 1 anchor through the top of the kneecap. The anchor stays fixed in place outside the bottom of the tunnel. The same process is repeated for the second anchor.

The surgeon then pushes the anchors into the small slits made in the patellar tendon so they do not cause irritation under the skin. The surgeon then uses the sutures from the soft anchors to place stitches through both sides of the quadriceps tendon. After the stitches are in place, the surgeon pulls on the sutures to tighten the torn tendon down to the top of the kneecap.

The surgeon bends and straightens the knee to check the tension and makes sure that there is no gap between the tendon and the kneecap. If needed, additional tension can be applied. The surgeon then ties the sutures together and cuts off the remaining strands. The surgeon will close the skin incision, and the quadriceps tendon repair is complete.