Novel repair of a quadriceps tendon rupture after a total knee arthroplasty using gracilis and semitendinosus autografts

Multiple techniques have been described for repair of quadriceps tendon rupture after total knee arthroplasty (TKA) with unsatisfactory outcomes. We present a novel technique for repair using hamstring tendon autografts. A 54 year-old morbidly obese patient presented five months after quadriceps tendon rupture. Direct repair was performed using two anchors in the patella in addition to augmentation with semitendinosus and gracilis tendon autografts. Satisfactory outcomes were achieved with no residual pain and ability to perform a straight leg raise at three weeks postoperatively. There was no extensor lag at five weeks postoperatively. Most previous reports of a similar complication were treated using synthetic materials. Using hamstring tendon autografts as described in this report provides an alternative surgical option for reconstruction of quadriceps tendon rupture in the setting of TKA, with potentially favorable outcomes and minimal donor site morbidity. Further studies are needed to evaluate long-term outcome of this procedure and to delineate the gold standard of treatment.