Sartorius muscle transfer for chronic quadriceps tendon rupture: A prospective study

Background: Quadriceps tendon rupture (QTR) is an uncommon injury. In chronic QTR there may be a large defect and direct repair is not possible with sutures or transosseous anchors. There is no gold standard surgical procedure for the treatment of chronic QTR. We propose a novel technique in which the quadriceps tendon (QT) is reconstructed using a transfer of ipsilateral sartorius tendon. Methods: Between January 2002 and April 2020, 19 patients undergoing sartorius muscle transfer for chronic QTR were prospectively recruited. The Knee Society Score (KSS), range of motion (ROM), and Medical Research Council (MRC) Scale for QT muscle strength were collected preoperatively and at a minimum of 2 years follow up. Results: The mean age of our cohort was 53.4 ± 9.8 years with a female patient count of 12 (54%). The mean body mass index recorded was 28.5 ± 3.2 kg/m2 (range 23–30). At the mean follow up of 53.4 ± 28.1 months the mean KSS was 90.9 ± 6.3 (range 80–100) (P < 0.05), the mean ROM was 119.5 ± 9.9° for flexion (range 100–130) (P < 0.05) and the mean extension lag was 3.8 ± 5.1° (range 0–15) (P < 0.05). The mean MRC scale was 4.5 ± 0.7 (range 3–5) (P < 0.05). The most frequent complication was QT hypotrophy; it was noted in 14 patients. Conclusion: Satisfactory clinical outcomes of ipsilateral sartorius muscle transfer for chronic QTR can be expected a mean of 4.4 years after surgery.