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Change in Surgical Repair of Torn Quadriceps Tendon
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Posted on: 07/16/2008
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There's a new method emerging for surgical repair of a ruptured quadriceps tendon. The standard repair uses interlocking continuous sutures. The ends of the torn tendon are reattached through holes drilled in the patella. The new technique uses suture anchors.
In this report, surgeons from the University of North Carolina - Chapel Hill describe the new approach in detail. Drawings and patient photos are used to show the surgeon how it's done. Five case examples are reported to help us understand how and when this procedure is used.
Suture anchors can be used for partial and complete ruptures. They can also be used in both acute (recent) and chronic (long-standing) injuries. In chronic injuries, the tendon may have retracted (pulled back) too far for this method alone. The surgeon will have to combine other techniques to make the repair.
Suture anchors are not advised if there is an infection or if the patient also fractured the patella (knee cap) at the time of the quadriceps rupture. Despite these few limitations, the use of suture anchors is expanding in many other areas of the body.
The authors point out the advantages of this method. Besides being a relatively simple technique, it reduces time in the operating room. After surgery, patients appear to have better resistance and minimal stress along the suture line during motion. The repair is stronger and less likely to fail compared with more traditional approaches.
The goal to restore motion as quickly as possible and prevent stiffness is met early with anchor sutures. Patients return to work and play much faster. The incision line is much smaller with this technique. That gives a better appearance afterwards but also means less tissue disruption during the surgery.
At the present time, there are only 10 reported cases of quadriceps tendon repair using suture anchors. More study is needed before adopting this approach. The authors suggest a study comparing results of the traditional approach with this newer method.
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References:
Brandon D. Bushnell, MD, et al. The Use of Suture Anchors to Repair the Ruptured Quadriceps Tendon. In Current Orthopaedic Practice. May/June 2008. Vol. 19. No. 3. Pp. 314-320.
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