Case technique report: an allograft “sandwich” reconstruction technique of a massive retracted chronic quadriceps tendon rupture

Introduction and Importance: The surgical reconstruction of chronic quadriceps tendon ruptures can be challenging, particularly in the neglected massive retracted tears and in previous failed surgery. Chronic quadriceps tendon ruptures result in the retraction of collagen fibers, leading to a progressive loss of their multilayered structure. The failure of acute quadriceps repair is an uncommon complication, with recorded failures in about 2% (range: 0-8.3%) of cases. Case Presentation: This report aims to describe a novel reconstruction procedure for chronic quadriceps rupture that uses an allograft in a sandwich fashion to improve fixation. Clinical Discussion: In the event of a quadriceps tendon repair failure, future repairs are frequently impeded by muscle wasting, tendon scarring, and retraction. Various surgical methods for treating quadriceps tendon rupture have been described in the literature, such as the use of synthetic mesh, autografts, and allografts with limited outcomes. However, there is no gold standard surgical technique. Conclusion: The utilization of double allograft tendons in quadriceps reconstruction presents a viable alternative technique for addressing failed chronic quadriceps rupture.