Treatment of neglected quadriceps tendon ruptures using LARS™ ligament augmentation: A case series

Abstract

Background: Late presentation of Quadriceps tendon rupture (QTR) is rare. Treatment of neglected QTR's can be challenging due to scar tissue and muscle wasting and may require augmentation. Delayed tendon repairs tend to have less favourable outcome compared to acute repairs. There are very few case reports of delayed repair using various techniques. Methods: a case series of 5 patients (6 tendon ruptures) presenting late with quadriceps tendon rupture. Repair was performed using a Codivilla VY plasty to extend the tendon, followed by LARS artificial ligament augmentation. All patients then received 6 weeks targeted physiotherapy after wound healing. Results: Repair using our technique was possible in all patients. No patients needed to return to theatre due to re-rupture or infection. Only one patient required oral antibiotics for a superficial wound infection. No patient was left with a functional deficit following physiotherapy, with 4 of the 6 repairs achieving a full range of movement. Conclusions: VY plasty followed by LARS augmentation can be used safely and reproducibly for the repair of delayed presentation quadriceps tendon ruptures in our cohort comprising of both healthy and co-morbid patients to achieve good functional results.

Keywords

• Quadriceps tendon rupture
• Quadriceps tendon augmentation
• Knee extensor mechanism