Quadriceps and Patella Tendon Repair Surgery Overview

Surgery to repair the quadriceps or patella tendon is done to restore function and strength to the knee following tendon injuries. The quadriceps tendon connects the quadriceps muscle to the patella (kneecap), while the patellar tendon connects the patella to the tibia (shinbone). Injuries to these tendons can occur due to trauma or overuse, leading to pain, swelling, and difficulty straightening the knee. The surgical procedure involves reattaching the tendon to the bone, often using sutures or grafts, to facilitate healing and regain mobility. Post-surgery, a structured rehabilitation program is essential for optimal recovery and return to daily activities or sports.

3D illustration showing human knee joint with femur, articular cartilage, meniscus, medial collateral ligament, articular cartilage, patella, kneecap, fibula, tibia, quadriceps tendon, patellar tendon

Step-by-Step Outline of Quadriceps and Patella Tendon Repair Surgery

  1. Preoperative Preparation

    • The patient is assessed in the clinic, including a physical examination and imaging studies (e.g., X-rays, MRI).

      Informed consent is obtained, and the surgical plan is discussed.

      The patient is instructed on preoperative fasting and medication guidelines.

  2. Positioning and Anesthesia

    • The patient is brought to the operating room and placed on the surgical table, usually in a supine position.

    • The knee is typically placed at a slight flexion to allow optimal access.

    • General anaesthesia or a regional nerve block is administered to ensure pain control during the procedure.

  3. Surgical Approach

    • A midline, lateral or longitudinal incision is made over the knee, depending on the specific characteristics of the tear.

    • The skin and subcutaneous tissues are carefully retracted to expose the knee joint.

  4. Identification of Tendons

    • The quadriceps and patellar tendons are located and assessed for the extent of the injury.

    • Identification of any associated injuries, such as fracture of the patella.

    • Any torn or damaged tissue is cleaned and prepared for repair.

  5. Surgical Technique for Repair

    • For a complete tear, the tendon ends are carefully dissected and aligned back to their normal anatomical locations.

    • Heavy non-absorbable sutures are passed through the healthy part of the tendon and the remaining tendon stump.

    • The sutures are tied securely to hold the tendon in place, ensuring proper tension. If necessary, additional fixation devices such as specialty anchors may be used to enhance stability.

    • Reattach any additional damaged structures, if necessary, e.g., reinstituting the synovial lining or repairing any meniscal tears.

  6. Closure

    • The soft tissue layers are carefully closed, starting with the fascia and ending with the skin.

    • Sterile dressings are applied to protect the surgical site.

  7. Post Operative Care

    • The patient is transferred to the recovery room for monitoring as the anaesthesia wears off.

    • Vital signs are monitored, and pain management is initiated.

    • Application of a knee brace or immobilizer, if indicated.

  8. Rehabilitation

    • A structured rehabilitation program is outlined, typically involving physical therapy that begins shortly after surgery focused on range of motion and gradual strengthening.

    • Follow-up appointments are scheduled to monitor healing and progress.

  9. Long-Term Care

    • The patient is advised on activity restrictions and signs of complications to monitor during recovery.

    • Full rehabilitation is often necessary, with gradual resumption of activities over the following months based on healing and strength assessments.

This straightforward outline covers the fundamental steps in quadriceps and patellar tendon repair surgery. Each case may require specific adjustments based on individual circumstances.