Patellar Tendon Reconstruction Using Quadriceps, Semitendinosus, and Gracilis Autografts With Ultra-high Molecular Weight Polyethylene Tape Augmentation: A Novel Technique

Abstract

Background: Chronic patellar tendon ruptures are challenging injuries to treat and can be debilitating to patients. Optimal treatment of these extensor mechanism injuries occurs in the acute postinjury period. When these injuries become chronic, they are increasingly difficult to treat effectively. Purpose: We present a case of chronic patellar tendon rupture in a young athletic male who was treated with quadriceps, semitendinosus, and gracilis autograft. To our knowledge, there have been no other reports of using a quadriceps autograft with a bone plug to reconstruct a chronic patellar tendon injury. Patients and Methods: A healthy male under the age of 18 presented in a delayed manner to our clinic with complaints of left knee pain and inability to straighten the knee. His imaging and clinical exam found that he had a patellar tendon rupture, ∼15-degree extensor lag, flexion to 140 degrees, and was unable to straight leg raise or perform any active extension of the knee. He had significant atrophy of his vastus musculature at the knee. The rupture was treated with quadriceps, semitendinosus, and gracilis autograft. Results: At 6 months follow-up, our patient had achieved full extension, flexion to 135 degrees, and 4 of 5 quadriceps strength. He returned to routine physical activity and was satisfied with his results to date. At 1 year’s follow-up, the patient had full extension and flexion to 140 degrees and had resumed playing recreational soccer. Conclusion: Treating chronic patellar tendon rupture with quadriceps, semitendinosus, and gracilis autograft resulted in a positive outcome for this difficult-to-treat injury.