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.
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Azar FM. Chapter 46: Traumatic disorders. In: Canale ST, Beaty JH, eds. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, PA: Mosby/Elsevier; 2008:2737.
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.
Chbinou N, Frenette J. Insulin-dependent diabetes impairs the inflammatory response and delays angiogenesis following Achilles tendon injury. Am J Physiol Regul Integr Comp Physiol. 2004;5:R952–7.
Chen AL, Shapiro JA, Ahn AK, Zuckerman JD, Cuomo F. Rotator cuff repair in patients with type I diabetes mellitus. J Shoulder Elbow Surg. 2003;5:416–421.
DeFranco MJ, Derwin K, Iannotti JP. New therapies in tendon reconstruction. J Am Acad Orthop Surg. 2004;5:298–304.
Evans PD, Pritchard GA, Jenkins DH. Carbon fibre used in the late reconstruction of rupture of the extensor mechanism of the knee. Injury. 1987;1:57–60.
Getgood A, Bollen S. What tissue bankers should know about the use of allograft tendons and cartilage in orthopaedics. Cell Tissue Bank. 2010;1:87–97.
Ilan DI, Tejwani N, Keschner M, Leibman M. Quadriceps tendon rupture. J Am Acad Orthop Surg. 2003;3:192–200.
Levy M, Goldstein J, Rosner M. A method of repair for quadriceps tendon or patellar ligament (tendon) ruptures without cast immobilization. preliminary report. Clin Orthop Relat Res. 1987;218:297–301.
Longo UG, Lamberti A, Maffulli N, Denaro V. Tendon augmentation grafts: A systematic review. Br Med Bull. 2010:165–188.
Maffulli N, Longo UG, Maffulli GD, Khanna A, Denaro V. Achilles tendon ruptures in diabetic patients. Arch Orthop Trauma Surg. 2010.
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.
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.
Valdes MA, Thakur NA, Namdari S, Ciombor DM, Palumbo M. Recombinant bone morphogenic protein-2 in orthopaedic surgery: A review. Arch Orthop Trauma Surg. 2009;12:1651–1657.
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.
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Druskin, S.C., Rodeo, S.A. Novel Treatment of a Failed Quadriceps Tendon Repair in a Diabetic Patient Using a Patella-Quadriceps Tendon Allograft. HSS Jrnl 9, 195–199 (2013). https://doi.org/10.1007/s11420-012-9285-9
- Quadriceps Tendon
- Tendon Healing
- Semitendinosus Tendon
- Tendon Allograft
- Absorbable Collagen Sponge