Dave Udit, Rubin Jared, Morgan Jacob T, Chang Nicole, Gerhold Cameron, Bi Andrew S, Atkins Myles, Gómez-Verdejo Fernando, Verma Nikhil N, Chahla Jorge
Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA.
University of Illinois College of Medicine, Chicago, IL, USA.
J Orthop. 2025 May 26;67:214-222. doi: 10.1016/j.jor.2025.05.046. eCollection 2025 Sep.
The quadriceps tendon (QT), which is formed by the confluence of the vastus intermedius, vastus lateralis, vastus medialis, and rectus femoris muscles plays a vital role in knee extension, hip flexion, and lower extremity mobility. The purpose of this systematic review is to evaluate post-operative outcomes, range of motion, and complications in patients who undergo quadriceps tendon repair.
In accordance with PRISMA guidelines, PubMed, Embase, and Cochrane Library databases were searched in August 2024 for studies published after 2004. Studies were included if they evaluated patients who underwent quadriceps tendon (QT) repair with any technique, were prospective or retrospective studies, and reported outcomes or complications. Studies not written in English or that did not evaluate complications or outcomes following QT repair were excluded.
The initial screen identified 662 studies, 6 of which were included. There were three retrospective case series, two retrospective cohort studies, and one prospective non-randomized study. Each study had low risk of bias. A total of 324 patients (89.5 % male) were included. Mean age across studies ranged from 32.0 to 65.8 years. Five studies pertained to patients over 50 years old; one study focused on patients under age 40. Otherwise, there were similar patient demographics across studies. Fixation techniques included transosseous tunnels, suture anchors, simple sutures, and adjustable cortical fixation. Mean post-operative Lysholm scores ranged from 85.4 to 94.0 (range 30-100). Full extension was reached by 88.7-100 % of patients. Mean knee flexion across studies ranged from 124.3 to 133.0°, with overall ranges of 110-150°. Re-rupture or failure occurred in 0-15.4 % of patients. Other complications included VTE (0-15.4 %), arthrofibrosis (0-7.7 %), infection (0-2.0 %), paresthesias over the anterior knee (0-13.2 %), and wound dehiscence (0-7.7 %).
Quadriceps tendon repair restores extensor mechanism function in patients with a low complication rate. There are no differences in outcomes or complications based on operative technique used. Decisions regarding operative technique should be tailored to individual patient characteristics and surgeon preferences with special consideration of medical comorbidities and systemic diseases that can affect tissue quality and post-operative healing.
Level IV, systematic review of level II- IV studies.
股四头肌肌腱（QT）由股中间肌、股外侧肌、股内侧肌和股直肌汇合而成，在膝关节伸展、髋关节屈曲和下肢活动中起着至关重要的作用。本系统评价的目的是评估接受股四头肌肌腱修复的患者的术后结局、活动范围和并发症。
根据PRISMA指南，于2024年8月在PubMed、Embase和Cochrane图书馆数据库中检索2004年后发表的研究。纳入的研究需评估采用任何技术进行股四头肌肌腱（QT）修复的患者，为前瞻性或回顾性研究，并报告结局或并发症。未用英文撰写或未评估QT修复后并发症或结局的研究被排除。
初步筛选出662项研究，其中6项被纳入。有3项回顾性病例系列研究、2项回顾性队列研究和1项前瞻性非随机研究。每项研究的偏倚风险较低。共纳入324例患者（89.5%为男性）。各研究的平均年龄在32.0至65.8岁之间。5项研究涉及50岁以上的患者；1项研究关注40岁以下的患者。其他方面，各研究的患者人口统计学特征相似。固定技术包括经骨隧道、缝线锚钉、简单缝线和可调皮质固定。术后Lysholm评分的平均值在85.4至94.0之间（范围为30 - 100）。88.7% - 100%的患者达到完全伸展。各研究的平均膝关节屈曲度在124.3至133.0°之间，总体范围为110 - 150°。0% - 15.4%的患者发生再断裂或失败。其他并发症包括静脉血栓栓塞（0% - 15.4%）、关节纤维化（0% - 7.7%）、感染（0% - 2.0%）、膝前部感觉异常（0% - 13.2%）和伤口裂开（0% - 7.7%）。
股四头肌肌腱修复可恢复伸肌机制功能，并发症发生率较低。基于所采用的手术技术，结局或并发症无差异。手术技术的决策应根据个体患者特征和外科医生的偏好进行调整，并特别考虑可能影响组织质量和术后愈合的内科合并症和全身性疾病。
IV级，对II - IV级研究的系统评价。
