Arthroscopy Techniques (May 2025)
Quadriceps Tendon Repair Using Knotless All-Suture Anchors With Transosseous Fixation
Abstract
Quadriceps tendon ruptures are significant injuries that impair knee function and mobility. Complete disruption of the knee extensor mechanism requires prompt operative repair to restore function. The 2 most popular techniques for tendon repair use either transosseous drill tunnels with suture fixation or unicortical drill holes with suture anchors. Each method is associated with advantages and disadvantages. Challenges of transosseous suture repair include knot volume and an increased risk of repair gapping after tensioning. Complications related to traditional suture anchor repair often are related to implant pullout and/or patella fracture. All-suture anchors used in a transosseous approach minimize these risks while combining the benefits of transosseous suture repair with the biomechanical advantages of suture-anchor fixation. The purpose of this Technical Note is to describe a technique that addresses limitations associated with current quadriceps tendon repair techniques by using a hybrid approach with knotless all-suture anchors through 2 transosseous patella bone tunnels.