PMC5634587_01
Coronal (a) and sagittal (b) representative magnetic resonance imaging (MRI) images denoting a quadriceps rupture in an otherwise healthy 17-year-old competitive athlete.
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The imaging revealed a full-thickness quadriceps tendon tear, predominantly along the lateral aspect, with an associated focal tear of the vastus lateralis muscle (Figure 1).
Intraoperative picture of the full-thickness quadriceps tear. Incision is slightly lateral to midline.
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The quadriceps was visualized, revealing a full-thickness rupture of the rectus femoris, vastus intermedius, and vastus lateralis tendon at the bone-tendon junction (Figure 2).
Anchor being placed in the superolateral quadriceps tendon footprint of the proximal pole of the patella.
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The superior pole of the patella along the quadriceps insertion was predrilled with an 11/64 inch drill bit, and a triple loaded 5.5 PEEK corkscrew suture anchor (Arthrex, Naples, Florida) was placed (Figure 3).
(a) Sequential Krackow suturing of the tendon tear with the anchor suture. (b) The final repair construct including the Krackow stitches of the anchor sewn into the patella periosteum.
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Three running Krackow sutures (one medial and two lateral) were placed and anchored on the distal quadriceps tendon to reinforce and ensure complete coverage of the quadriceps tendon footprint (Figure 4). The final repair construct reapproximated the torn tendon edge to the superolateral aspect of the superior pole of the patella (Figure 4).
Primary healed scar without sings of infection with full knee extension (a) and full knee flexion (b) at six months after operative visit.
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Physical exam demonstrated good quadriceps activation, with appreciable muscle atrophy, and full range of motion (Figure 5).