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A Method of Repair for Quadriceps Tendon or Patellar Ligament (Tendon) Ruptures Without Cast Immobilization

LEVY, M.*; GOLDSTEIN, J.**; ROSNER, M.

Clinical Orthopaedics and Related Research: May 1987 - Volume 218 - Issue - p 297–301
Section III BASIC SCIENCE AND PATHOLOGY: PDF Only
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The quadriceps tendon and patellar tendon (ligament) was repaired with a Dacron vascular graft used as a tension suture material. In cases of quadriceps tendon ruptures, the Dacron graft is passed transversely through the patellar ligament just below the patella and crossed transversely at the level of the musculotendinous junction with two loops applying tension to the tendon, which brings the tendon ends together by creating a solid structure. In cases of patellar ligament ruptures, the Dacron graft is passed through a hole in the tibia posteriorly to the tibial tuberosity instead of through the patellar ligament below the patella. This technique enables early mobilization on the first day after surgery. The technique was first tested on six dogs with severed quadriceps tendons and patellar ligaments that were repaired with this suture method. All of the animals recovered from surgery and walked and ran normally on the repaired legs within 27 days and with only mild limping after 17 days. The technique was then used on six patients, four with complete quadriceps tendon rupture and two with complete tear (avulsion) of the patellar ligament (tendon). In all of the patients, excellent surgical results were obtained and leg immobilization was virtually eliminated. Physical therapy was prescribed the first day after surgery. The rehabilitation period was significantly reduced.

From the Orthopaedic Department of Yosephtal Medical Center, Eilat and the Pathological Institute, Soroka Medical Center, Beer-Sheva, Israel.

* Chief of Orthopaedics, Yosephtal Medical Center, Eilat, and Associate Professor, Faculty of Medicine, Ben-Gurion University of the Negev, Beer-Sheva, Israel.

** Chief Physician, Soroka Institute for Pathology, and Senior Lecturer in Pathology, Ben-Gurion University of the Negev, Beer-Sheva, Israel.

† Lecturer, Ben-Gurion University of the Negev, Beer-Sheva, Israel.

© Lippincott-Raven Publishers.