Evidence map›Paper›PMID 40395261›Full record

ArticleCureus2025

Leeds-Keio Ligament for the Reconstruction of Delayed Patella and Quadriceps Tendon Rupture: Time to Revisit?

Gopalkrishna G Verma, Jawad Sultan, Kan Nyunt, Mobeen Ismail

Abstract readCase Reports
In one paragraph

Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Grafts in tendon repair.Materials today. Bio · 2026
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Gopalkrishna G VermaTrauma and Orthopaedics, Manchester University NHS Foundation Trust, Manchester, GBR.
Jawad SultanTrauma and Orthopaedics, Manchester University NHS Foundation Trust, Manchester, GBR.
Kan NyuntTrauma and Orthopaedics, Manchester Univeristy NHS Foundation Trust, Manchester, GBR.
Mobeen IsmailTrauma and Orthopaedics, Manchester University NHS Foundation Trust, Manchester, GBR.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Ruptures of the knee extensor apparatus in elderly individuals or following total knee replacement present a significant functional limitation and surgical challenge. The Leeds-Keio ligament, a synthetic graft, has been historically used for reconstruction but has seen declining popularity with advancements in biological grafts. This study revisits the application of the Leeds-Keio ligament in managing chronic and complex extensor mechanism ruptures. It is a retrospective review of five patients (mean age 73.6 years) who underwent surgical reconstruction of the ruptured patella or quadriceps tendons with the Leeds-Keio ligament between 2022 and 2025. The surgical technique involved a figure-of-eight configuration to bridge or augment the repair. The postoperative protocol included initial immobilisation followed by a progressive rehabilitation program. All patients achieved satisfactory functional recovery with independent mobilisation at the latest follow-up, with some exhibiting mild residual extension lag. The diverse presentations included one case with a chronic 10 cm gap quadriceps tendon rupture that required quadriceps V-Y plasty and bridging with Leeds-Keio ligament. Three cases with patella tendon ruptures after total knee arthroplasty (TKA) had patella tendon reconstruction with the Leeds-Keio ligament, and notably, two TKA dislocations required revision to a hinged knee prosthesis for stability. Another case involved a re-ruptured primary patella tendon repair four weeks post surgery that needed reconstruction with a Leeds-Keio ligament. No major complications, such as deep infection or graft failure, were observed in this small series. The Leeds-Keio ligament may be a viable option for reconstructing complex chronic patella and quadriceps tendon ruptures in elderly patients, including revision scenarios and those with concomitant TKA complications, providing satisfactory early functional outcomes. Careful patient selection and individualised treatment strategies are essential to optimise outcomes.

Indexed as

elderlyknee extensor mechanism ruptureleeds-keio ligamentpatella tendon rupturequadriceps tendon rupturesynthetic grafttotal knee arthroplasty

Identifiers

PMID40395261
PMCPMC12091579

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