Successful Surgical Repair of Acute Quadriceps Tendon Rupture Utilizing Cortical Button Fixation: A Case Report

Patient: Male, 69-year-old Final Diagnosis: Quadriceps tendon rupture Symptoms: Knee pain Medication:— Clinical Procedure: Surgery Specialty: Orthopedics and Traumatology OBJECTIVE: Unusual setting of medical care BACKGROUND: Timely diagnosis and surgical treatment are often needed to restore function of the extensor mechanism after rupture of the quadriceps tendon. Several techniques for quadriceps tendon repair have been reported, including suture anchors and bone tunnels. Cortical button fixation, or the use of an adjustable cortical fixation device, is a local and biomechanically strong internal brace technique used to treat ligament and tendon injuries. This report is of a 69-year-old man who experienced a quadriceps tendon rupture while golfing and underwent a successful surgical repair using cortical button fixation. CASE REPORT: A 69-year-old man sustained an injury after slipping while golfing. He had immediate left knee pain and inability to bear weight. Radiographs demonstrated patella baja with an acute superior pole avulsion fracture of the patella, consistent with rupture of the quadriceps tendon. Surgical repair was discussed. Technique: After soft tissue debridement, the quadriceps tendon was debrided from the frayed and edematous edges. Two Krackow-type stitches were placed with #2 Fibertape and passed through 2 cortical buttons. Two bone tunnels were drilled from the superior to the inferior poles of the patella, bicortically. The cortical button was passed and appropriately tensioned. CONCLUSIONS: Although acute quadriceps tendon rupture is commonly treated with transosseous suture repair and suture anchor repair, this report demonstrates that cortical button fixation was a successful procedure with strong biomechanical properties, resulting in the early return of function and range of motion.