The quadriceps femoris tendon is a critical component of the extensor mechanism and one of the strongest tendons in the human body. It is a robust tendon composed of four layers. Quadriceps tendon ruptures (QTR) can result from trauma or systemic causes that lead to loss of quadriceps tendon strength, resulting in pain, loss of active knee extension, and a prolonged rehabilitation course. Techniques described in the literature for QTR repair are predominantly open surgeries that utilize either suture anchors or bone tunnels. However, limited data are available regarding arthroscopic techniques. This technical note describes a surgical technique for arthroscopic quadriceps tendon repair utilizing the Jose Reyes Configuration (JRC) technique. This configuration is characterized by a combined use of a single suture anchor and two bone tunnels for stabilization, aiming for enhanced biomechanical alignment and cost-efficiency.
References
[1]
Dong, H., Yang, J., Yu, H., Zhu, J. and Yang, J. (2024) Rebuilding Strength: Surgical Intervention and Rehabilitation for Bilateral Spontaneous Quadriceps Tendon Rupture—A Case Report. Frontiers in Surgery, 11, Article 1430774. https://doi.org/10.3389/fsurg.2024.1430774
[2]
Olewnik, Ł., Zielinska, N., Ruzik, K., Karauda, P., Podgórski, M., Borowski, A., et al. (2023) A New Look at Quadriceps Tendon—Is It Really Composed of Three Layers? The Knee, 40, 292-304. https://doi.org/10.1016/j.knee.2022.11.005
[3]
Moahmmad, A, and Abdullah, A. (2024) The Effect of the Quadriceps Muscle on Sports Performance and Injury Prevention: Biomechanical Perspective. Journal of Propulsion Technology, 45, 532-546.
[4]
Bordoni, B. and Varacallo, M.A. (2025) Anatomy, Bony Pelvis and Lower Limb: Thigh Quadriceps Muscle. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK513334/
[5]
Pope, J.D., El Bitar, Y., Mabrouk, A. and Plexousakis, M.P. (2025) Quadriceps Tendon Rupture. StatPearls Publishing.
[6]
Quzli, A.A., Ali-Qazalbash, Z.M., Alkhatib, S.A. and Karthikappallil, D. (2025) Quadriceps Tendon Ruptures: A Clinical Review. Cureus, 17, e95757. https://doi.org/10.7759/cureus.95757
[7]
Mimpen, J.Y., Baldwin, M.J., Paul, C., Ramos-Mucci, L., Kurjan, A., Cohen, C.J., etal. (2025) Exploring Cellular Changes in Ruptured Human Quadriceps Tendons at Single-Cell Resolution. The Journal of Physiology, 603, 4535-4554. https://doi.org/10.1113/jp287812
[8]
Arnold, E.P., Sedgewick, J.A., Wortman, R.J., Stamm, M.A. and Mulcahey, M.K. (2022) Acute Quadriceps Tendon Rupture: Presentation, Diagnosis, and Management. JBJS Reviews, 10, e21.00171. https://doi.org/10.2106/jbjs.rvw.21.00171
[9]
Coladonato, C., Perez, A.R., Sonnier, J.H., Looney, A.M., Delvadia, B.P., Okhuereigbe, D.O., et al. (2023) Similar Outcomes Are Found between Quadriceps Tendon Repair with Transosseous Tunnels and Suture Anchors: A Systematic Review and Meta-Analysis. Arthroscopy, Sports Medicine, and Rehabilitation, 5, Article 100807. https://doi.org/10.1016/j.asmr.2023.100807.
[10]
Yanke, A.B., Dandu, N., Trasolini, N.A., Darbandi, A.D., Walsh, J.M., Rice, R., et al. (2023) Suture Anchor-Based Quadriceps Tendon Repair May Result in Improved Patient-Reported Outcomes but Similar Failure Rates Compared to the Transosseous Tunnel Technique. Arthroscopy: The Journal of Arthroscopic & Related Surgery, 39, 1483-1489.e1. https://doi.org/10.1016/j.arthro.2022.11.031
[11]
Katsma, M.S., Land, V., Renfro, S.H., Culp, H. and Balazs, G.C. (2025) Evaluating Failure Rates of Primary Quadriceps Tendon Repairs across Different Surgical Techniques. Orthopaedic Journal of Sports Medicine, 13, Article 7. https://doi.org/10.1177/23259671241303924
[12]
Saito, H., Shimada, Y., Yamamura, T., Yamada, S., Sato, T., Nozaka, K., et al. (2015) Arthroscopic Quadriceps Tendon Repair: Two Case Reports. Case Reports in Orthopedics, 2015, 1-10. https://doi.org/10.1155/2015/937581
Grob, K., Manestar, M., Filgueira, L., Ackland, T., Gilbey, H. and Kuster, M.S. (2016) New Insight in the Architecture of the Quadriceps Tendon. Journal of Experimental Orthopaedics, 3, Article 32.
[15]
Strauss, M., Kennedy, M.L., Brady, A., Moatshe, G., Chahla, J., LaPrade, R.F., et al. (2021) Qualitative and Quantitative Anatomy of the Human Quadriceps Tendon in Young Cadaveric Specimens. Orthopaedic Journal of Sports Medicine, 9, e23259671211037305. https://doi.org/10.1177/23259671211037305
