Suture anchors - quadriceps tendon reimplantation

Case contributed by Jerry Jiang

Presentation

Presented with weakness of knee extension impairing ambulation.

Patient Data

Age: 35 years
Gender: Male
MRI

Presenting MRI

There is a complete tear through the quadriceps muscle tendon with an intact patellar tendon, resulting in a low-lying patella. 

Patient subsequently underwent a right quadriceps tendon reconstruction with Achilles tendon cadaver allograft performed by orthopedic surgery.

MRI

Postoperative MRI

Well-reconstructed quadriceps muscle tendon with intact allograft. Severe soft tissue edema of anterior thigh and knee likely from surgery 1 week prior.

X-ray

Routine X-ray

4 months post-op. Two suture anchors within the patella are seen from implantation of the Achilles tendon allograft into the patella. There is also diffuse soft tissue edema overlying the knee. 

Case Discussion

Transosseous suturing is the traditional method for reimplantation of the quadriceps tendon into the patella during surgical repair of a quadriceps tendon rupture. Suture anchors is a newer method where the anchor is drilled into the patella and the suture passes through an eyelet on the anchor rather than transosseously. Studies have demonstrated better biomechanics with suture anchors compared to transosseous suturing, and suggest comparable clinical outcomes 1,2. The appearance of the suture anchors is well-seen on the plain radiographs in this case.

 

This case was submitted with supervision and input from:

Soni C. Chawla, M.D.
Associate Professor
Department of Radiological Sciences
David Geffen School of Medicine at UCLA
Olive View - UCLA Medical Center 

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Case information

rID: 69689
Published: 24th Jul 2019
Last edited: 11th Sep 2019
Inclusion in quiz mode: Included

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