Revision Patellar Tendon Repair With Anchors, Allograft Augmentation, and Suspensory Fixation

Ruptures of the patellar tendon are rare but potentially devastating injuries reported to occur most commonly in active males in their third and fourth decades of life. Repair failure rates have been reported to range between 2% and 50% based on surgical technique used. There are several inherent challenges associated with revision patellar tendon repair, including quadriceps atrophy, contracture, tissue loss, excessive scarring, and improper patella height. There remains no consensus regarding ideal revision patellar tendon repair technique. The purpose of this Technical Note is to describe our preferred method for revision patellar tendon repair using suture anchors and allograft augmentation with adjustable loop suspensory fixation. On the basis of recent studies, we have carefully chosen our fixation and augmentation methods that have shown biomechanical promise, while allowing the surgeon to carefully titrate the patellar tendon length and accommodate for some patellar tendon tissue loss.