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Repair of a Chronic Ruptured Quadriceps Tendon Using a Medial Gastrocnemius-Hemisoleus-Calcaneal Block Flap

May 01, 2015

Contributors: Melvin Paul Rosenwasser, MD; Ryan Engdahl, MD; Derly Oscar Cuellar III, MD; Joseph Lombardi, MD; Jeffrey A Geller, MD; William B Macaulay, MD

Rupture of the extensor mechanism of the knee is a rare and serious complication of total knee arthroplasty, with rupture of the quadriceps tendon being an especially difficult type of such injury to manage. The failure of direct suture repair, autograft augmentation, or a local procedure to repair the extensor mechanism of the knee leaves the surgeon with limited options for restoring its function. For this situation, we present a technique for repair of a chronic ruptured quadriceps tendon using a novel flap consisting of medial gastrocnemius and hemisoleus muscle and Achilles tendon and terminating in a block of calcaneal bone, which provides a well-vascularized flap-tendon-bone block interposition that restores the extensor mechanism of the knee by spanning the gap in the quadriceps tendon.

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