Table 1.

Step-by-Step Technique for Quadriceps Tendon Repair With Large Tendon Defects

1. Patient positioning with knee in 20° flexion

2. Midline approach extending from 2 cm proximal to palpable defect to distal patella

3. Subcutaneous dissection and tendon exposure

4. Identification of the gap, debridement of nonviable tissue

5. Preparation of a trapezoidal recipient site in the native patella

6. Drilling of two 2.4-mm tunnels in the patella deeper than the previously created socket; Kirschner wire passage

7. Preparation of an Achilles tendon bony allograft on the back table to match the inverted trapezoidal shape created in the patella

8. Allograft insertion and fixation with Kirschner wires

9. Side-to-side native tendon–allograft suture

10. Layered closure