Novel repair of a quadriceps tendon rupture after a total knee arthroplasty using gracilis and semitendinosus autografts.

BACKGROUND: Multiple techniques have been described for repair of quadriceps tendon rupture after total knee arthroplasty (TKA) with unsatisfactory outcomes. We present a novel technique for repair using hamstring tendon autografts. METHODS: A 54 year-old morbidly obese patient presented five months after quadriceps tendon rupture. Direct repair was performed using two anchors in the patella in addition to augmentation with semitendinosus and gracilis tendon autografts. RESULTS: Satisfactory outcomes were achieved with no residual pain and ability to perform a straight leg raise at three weeks postoperatively. There was no extensor lag at five weeks postoperatively. CONCLUSIONS: Most previous reports of a similar complication were treated using synthetic materials. Using hamstring tendon autografts as described in this report provides an alternative surgical option for reconstruction of quadriceps tendon rupture in the setting of TKA, with potentially favorable outcomes and minimal donor site morbidity. Further studies are needed to evaluate long-term outcome of this procedure and to delineate the gold standard of treatment.

A Case Report of Acute Exertional Compartment Syndrome with Peroneal Nerve Palsy in an Adolescent Athlete.

INTRODUCTION: Acute following a chronic exertional compartment syndrome (CECS) is a known but uncommonly encountered complication of sports activity and its physiologic profile remains unclear to date. Failure to recognize and promptly treat this condition can lead to disastrous sequelae. CASE REPORT: We present the case of a 13-year-old lacrosse player with a history of CECS who developed unprovoked acute compartment syndrome. Despite emergent fasciotomy, she experienced intermittent episodes of peroneal nerve deficits. A peroneal nerve neurolysis was later performed which resulted in full resolution of her symptoms. CONCLUSION: This case stresses the importance of a high index of suspicion for compartment syndrome which if not treated in a timely fashion can have devastating consequences.