Novel Treatment of a Failed Quadriceps Tendon Repair in a Diabetic Patient Using a Patella-Quadriceps Tendon Allograft
- 315 Downloads
Recurrent quadriceps tendon rupture is a debilitating condition that may be challenging to treat, especially in the presence of systemic disease such as diabetes mellitus (Bedi et al., J Shoulder Elbow Surg 19:978–988, 2010; Chbnou and Frenette, Am J Physiol Regul Integr Comp Physiol 5:R952–R957, 2004; Chen et al., J Shoulder Elbow Surg 5:416–421, 2003). Many surgical treatment protocols have been proposed (Azar, in Canale and Beatty, eds., Campbell’s Operative Orthopedics, Mosby/Elsevier, Philadelphia, PA, 2008; Ilan et al., J Am Acad Orthop Surg 3:192–200, 2003; Rodeo and Izawa, in Garrett et al., eds., Principles and Practice of Orthopedic Sports Medicine, Lippincott Williams & Wilkins, Philadelphia, PA, 2000). We report the case of a diabetic male with multiple treatment failures. He ultimately sustained a good outcome following treatment with a novel surgical technique that utilized a patella quadriceps tendon allograft. Tendon allograft-to-native bone healing had previously failed in this patient, so we used a bone-tendon construct allograft to provide an allograft bone-to-native bone healing site. Now, 13 months postoperative, the patient has increased strength, minimal pain, 20 ° of extensor lag and 130 ° of flexion.
KeywordsQuadriceps Tendon Tendon Healing Semitendinosus Tendon Tendon Allograft Absorbable Collagen Sponge
Each author certifies that he or she has no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article.
Each author certifies that his or her institution approved the human protocol for this investigation; that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.
- 1.Azar FM. Chapter 46: Traumatic disorders. In: Canale ST, Beaty JH, eds. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, PA: Mosby/Elsevier; 2008:2737.Google Scholar
- 2.Bedi A, Fox AJ, Harris PE, Deng XH, Ying L, Warren RF, Rodeo SA. Diabetes mellitus impairs tendon-bone healing after rotator cuff repair. J Shoulder Elbow Surg. 2010.Google Scholar
- 5.DeFranco MJ, Derwin K, Iannotti JP. New therapies in tendon reconstruction. J Am Acad Orthop Surg. 2004;5:298–304.Google Scholar
- 8.Ilan DI, Tejwani N, Keschner M, Leibman M. Quadriceps tendon rupture. J Am Acad Orthop Surg. 2003;3:192–200.Google Scholar
- 10.Longo UG, Lamberti A, Maffulli N, Denaro V. Tendon augmentation grafts: A systematic review. Br Med Bull. 2010:165–188.Google Scholar
- 11.Maffulli N, Longo UG, Maffulli GD, Khanna A, Denaro V. Achilles tendon ruptures in diabetic patients. Arch Orthop Trauma Surg. 2010.Google Scholar
- 12.Rodeo SA, Izawa K. Chapter 39: Diagnosis and treatment of knee tendon injury. In: Garrett WE, Speer KP, Kirkendall DT, Kitkowski MD, eds. Principles and Practice of Orthopaedic Sports Medicine. Philadelphia, PA: Lippincott Williams & Wilkins; 2000:687.Google Scholar
- 13.Truong DT, Dussault RG, Kaplan PA. Fracture of the os peroneum and rupture of the peroneus longus tendon as a complication of diabetic neuropathy. Skeletal Radiol. 1995;8:626–628.Google Scholar