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      Trapezoidal Achilles Tendon Allograft Plug for Revision Quadriceps Tendon Repair With a Large Tendon Defect

      , B.S., , M.D., , P.A.-C., , M.D., , M.D., M.B.A., , M.D., Ph.D.

      Arthroscopy Techniques

      Elsevier

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          Abstract

          Revision quadriceps tendon repair presents a challenging problem for the treating surgeon because of associated anatomic defects such as large tendon-gap deficits and preexistent poor tissue quality. Current methods for revision quadriceps tendon repair use tendon autograft, which may predispose to additional morbidity because the repair relies only on soft tissue fixation. In this Technical Note, we describe a technique for revision of a failed quadriceps tendon repair with a large tendon gap using a trapezoidal plug Achilles tendon allograft. This technique constitutes a safe and effective approach to revising failed primary quadriceps tendon repairs, is suitable for large-gap defects, and has the ability to withstand large force transmissions.

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          Most cited references 11

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          Novel Augmentation Technique for Patellar Tendon Repair Improves Strength and Decreases Gap Formation: A Cadaveric Study

          Patellar tendon ruptures commonly are repaired using transosseous patellar drill tunnels with modified-Krackow sutures in the patellar tendon. This simple suture technique has been associated with failure rates and poor clinical outcomes in a modest proportion of patients. Failure of this repair technique can result from gap formation during loading or a single catastrophic event. Several augmentation techniques have been described to improve the integrity of the repair, but standardized biomechanical evaluation of repair strength among different techniques is lacking.
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            Simultaneous bilateral rupture of patellar tendons in diabetic hemodialysis patient: A case report

            Background: Bilateral rupture of the patellar tendon is a very rare injury, which takes place in relation to chronic systemic diseases. These injuries are known causes. Some of these causes are particular in patellar tendon rupture and another are in quadriceps tendon rupture. Case presentation: 70-year-old diabetic man with simultaneous bilateral patellar tendon disruption of proximal insertion without trauma, receiving long-term hemodialysis. Conclusions: In the present study, we report a case of patellar tendon rupture that has two differences with literature: first, renal failure is a known risk factor for quadriceps tendon rupture, and secondly, the prevalent age of patellar tendon rupture is less than 40 years. Clinical picture, diagnosis, pathogenesis and treatment are discussed. Finally, the literature is reviewed based on previous studies.
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              Spontaneous disruption of the bilateral knee extensor mechanism: a report of two cases.

              Spontaneous disruption of the knee extensor mechanism is associated with systemic diseases, steroid usage, and repeated microtrauma. Early repair or reconstruction is imperative for optimal outcome. We report 2 cases of spontaneous disruption of the bilateral knee extensor mechanism. The first patient had connective tissue disease and long-term steroid use. She had acute-on-chronic spontaneous bilateral patellar tendon rupture. She underwent reconstruction with an allograft and defunctioning wire. The second patient had end-stage renal failure with tertiary hyperparathyroidism and was on haemodialysis. He had a right patellar tendon rupture and a left quadriceps tendon rupture. He underwent primary repair of both tendons. Postoperatively, both patients followed a strict physiotherapy regimen and achieved good functional outcome.
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                Author and article information

                Contributors
                Journal
                Arthrosc Tech
                Arthrosc Tech
                Arthroscopy Techniques
                Elsevier
                2212-6287
                11 September 2019
                September 2019
                11 September 2019
                : 8
                : 9
                : e1031-e1036
                Affiliations
                Division of Sports Medicine, Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, U.S.A.
                Author notes
                []Address correspondence to Jorge Chahla, M.D., Ph.D., Department of Orthopaedic Surgery, Rush University Medical Center, 1611 W. Harrison St, Suite 300, Chicago, IL 60612, U.S.A. jorge.chahla@ 123456rushortho.com
                Article
                S2212-6287(19)30100-8
                10.1016/j.eats.2019.05.015
                6848963
                © 2019 by the Arthroscopy Association of North America. Published by Elsevier.

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                Categories
                Technical Note

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