Estudo epidemiológico das rupturas tendinosas do mecanismo extensor do joelho em um hospital de nível I

Albuquerque, Rodrigo Pires e; Prado, Juliano; Hara, Rafael; Ferreira, Evaldo César Macau Furtado; Schiavo, Leonardo; Giordano, Vincenzo; Amaral, Ney Pecegueiro do; Barretto, João Maurício

doi:10.1590/s0102-36162012000600008

Cited by 7 publications

(1 citation statement)

References 8 publications

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“…4 They are most common in males younger than 40 years of age and are usually the result of direct trauma. 1 Zernicke et al 23 estimated that a healthy tendon can withstand up to 17.5 times a subject's body weight before failing; however, other factors may predispose patients to tendon rupture, such as chronic renal failure, rheumatoid arthritis, repetitive microtrauma, lupus erythematous, fluoroquinolone use, or history of steroid use. 16 Patellar tendon ruptures are categorized into 3 types by location of the rupture: inferior pole of the patella, midsubstance, and tibial tuberosity.…”

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confidence: 99%

Biomechanical Analysis of Patellar Tendon Repair With Knotless Suture Anchor Tape Versus Transosseous Suture

Massey

Myers

McClary

et al. 2020

Orthopaedic Journal of Sports Medicine

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Background: Patellar tendon ruptures have routinely been repaired with transosseous suture tunnels. The use of knotless suture anchors for repair has been suggested as an alternative. Purpose: To compare the load to failure and gap formation of patellar tendon repair at the inferior pole of the patella with knotless suture anchor tape versus transosseous sutures. A secondary objective was to investigate whether either technique shows an association between bone density and load to failure. Study Design: Controlled laboratory study. Methods: A total of 20 human tibias with attached patellar and quadriceps tendons were sharply incised at the bone-tendon junction at the inferior pole of the patella. A total of 10 tendons were repaired using 2 knotless suture anchors in the inferior pole of the patella and a single suture tape with 2 core sutures. The other 10 tendons were repaired using No. 2 suture passed through 3 transosseous tunnels. A distracting force was then applied through the suture in the quadriceps tendon. Gap distance through load cycling at the repair site and maximum load at repair failure were then measured. Bone density was measured using computed tomography scanning. Results: No difference was found in the mean load to failure of knotless patellar tendon repair versus transosseous suture repair (367.6 ± 112.2 vs 433.9 ± 99 N, respectively; P = .12). After 250 cycles, the mean repair site gap distance was 0.85 ± 0.45 mm for the knotless patellar tendon repair versus 2.94 ± 2.03 mm for the transosseous suture repair ( P = .03). A small correlation, although not statistically significant, was found between bone density and load to failure for the knotless tape repair ( R 2 = 0.228; P = .66). No correlation was found between bone density and load to failure for the transosseous repair ( R 2 = 0.086; P = .83). Conclusion: Suture tape repair with knotless anchors for repair of patellar tendon rupture has comparable load to failure with less gap formation than transosseous suture repair. There is a small correlation between bone density and failure load for knotless anchor repair, which may benefit from further investigation. Clinical Relevance: Using knotless suture anchors for patellar tendon rupture repair would allow for a smaller incision, less dissection, and likely shorter operating time.

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mentioning

confidence: 99%

Biomechanical Analysis of Patellar Tendon Repair With Knotless Suture Anchor Tape Versus Transosseous Suture

Massey

Myers

McClary

et al. 2020

Orthopaedic Journal of Sports Medicine

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Patella Tendon Repair Reconstruction for Failed Fixation

Joslin,

Efremov,

Parisien

et al. 2024

Failed Fracture Fixation

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Complications and re-operations after extensor mechanism repair surgery in a large cross-sectional cohort: females and tobacco-users at highest risk for adverse outcomes

Oeding

Alrabaa

Wong

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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PurposeThere is little information on patients most at risk for poor outcomes following surgical repair of extensor mechanism tendon injuries. The purpose of this study is to provide an epidemiological overview of patients undergoing patellar or quadriceps tendon repair and to assess the incidence of postoperative complications, readmissions, and revision repairs among this population. MethodsRetrospective data were obtained using the PearlDiver database for patellar tendon repair and quadriceps tendon repair patients between 2010 and 2020. Baseline demographics, incidences of 90‐day readmissions and postoperative complications, and reoperation rates were collected for each group. Multivariate logistic regression was performed to assess the predictive power of each demographic variable on the incidence of postoperative complications and reoperations. ResultsIn total, 1543 patients underwent patellar tendon repair and 601 underwent quadriceps tendon repair. Complications within 90‐days were observed in 33.7% of patients with patellar tendon repair and 39.2% of patients with quadriceps tendon repair. Reoperation rates were 4.2% and 4.8% for patellar tendon repair and quadriceps tendon repair, respectively. Females in both patellar tendon repair and quadriceps tendon repair groups were at significantly higher risk for post‐operative complications (patellar tendon repair OR 3.0, 95% CI 2.4–3.7; quadriceps tendon repair OR 2.9, 95% CI 1.9–4.6; p < 0.001 for both). Older age (p < 0.001), female gender (p < 0.001), CCI (p < 0.001), tobacco use (p < 0.001), and obesity (p < 0.01) were all predictors of experiencing at least one complication following patellar tendon repair. For quadriceps tendon repair, female gender (p < 0.001) and CCI (p < 0.001) were the strongest predictors of experiencing at least one complication, while older age, tobacco use, and obesity (p < 0.05 for all) were also significant independent predictors. ConclusionPatellar tendon repair patients are younger on average than quadriceps tendon repair patients. Although females are less likely to sustain extensor mechanism ruptures compared to males, females are significantly more likely to have at least one complication after quadriceps or patellar tendon repair. These findings may be used by surgeons, patients, and payors to understand who is most at risk for adverse outcomes following extensor mechanism repair surgery, resulting in earlier intervention and counseling to reduce the likelihood of a poor outcome following extensor mechanism repair surgery. Level of evidenceLevel III.

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Estudo epidemiológico das rupturas tendinosas do mecanismo extensor do joelho em um hospital de nível I

Cited by 7 publications

References 8 publications

Biomechanical Analysis of Patellar Tendon Repair With Knotless Suture Anchor Tape Versus Transosseous Suture

Biomechanical Analysis of Patellar Tendon Repair With Knotless Suture Anchor Tape Versus Transosseous Suture

Patella Tendon Repair Reconstruction for Failed Fixation

Complications and re-operations after extensor mechanism repair surgery in a large cross-sectional cohort: females and tobacco-users at highest risk for adverse outcomes

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