Quadriceps tendon ruptures: a narrative review.

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomedical Engineering

Background:

• Quadriceps tendon ruptures occur in native knees and knees with prior total knee arthroplasty (TKA).
• Complete ruptures necessitate surgical intervention for optimal patient function.
• Optimal surgical techniques for native and post-TKA ruptures are debated, with limited consensus for post-TKA cases.

Purpose of the Study:

• To review contemporary treatment options and outcomes for quadriceps tendon ruptures.
• To compare results for ruptures in native knees versus those following TKA.
• To highlight challenges and areas for improvement in managing post-TKA ruptures.

Main Methods:

• A narrative review of English language literature up to November 2024.
• Inclusion of all article types related to quadriceps tendon ruptures in native and post-TKA knees.
• Focus on contemporary surgical repair and reconstruction techniques.

Main Results:

• Native quadriceps tendon ruptures treated with primary repair show reasonable outcomes, with comparable results between transosseous and suture anchor techniques.
• Quadriceps tendon ruptures following TKA are significantly more challenging to treat.
• High complication and failure rates are observed for primary repair, augmentation, and reconstruction in post-TKA ruptures, even with advanced allograft and synthetic mesh options.

Conclusions:

• Contemporary techniques offer generally reliable results for native quadriceps tendon ruptures.
• Post-TKA quadriceps tendon ruptures remain a significant clinical challenge with suboptimal outcomes.
• Further research is needed to improve surgical management and patient outcomes for post-TKA quadriceps tendon ruptures.