Comparison of adverse events and postoperative mobilization following knee extensor mechanism rupture repair: A systematic review and network meta-analysis

Serino, Joseph; Mohamadi, Amin; Orman, Sebastian; McCormick, Brian P; Hanna, Philip C.; Weaver, Michael J.; Harris, Mitchel B.; Nazarian, Ara; Keudell, Arvind von

doi:10.1016/j.injury.2017.10.013

Cited by 29 publications

(40 citation statements)

References 34 publications

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“…An immobilization of 6 weeks is often substituted with an early mobilization, in order to accelerate rehabilitation. However, Serino et al (9) showed a significantly higher adverse event rate with early mobilization, and a tendency to a higher additional surgery rate. Due to the lack of evidence of benefits of an early mobilization, it is difficult to provide recommendations.…”

Section: Discussionmentioning

confidence: 97%

“…In this review, we aimed to focus exclusively on patellar tendon ruptures occurring in patients practicing sport in order to evaluate their ability to return to sport. Indeed, patellar tendon ruptures are usually described in other contexts, especially in middle aged patients with inflammatory or metabolic disease (9,11). In the sport population, data are lacking, and ruptures remain infrequent despite the high frequency of patellar tendinopathy (6).…”

Section: Discussionmentioning

confidence: 99%

“…Surgical treatment is needed to restore the mechanical properties of the knee extensors (4). A healing time of several weeks is imperative, generally followed by a rehabilitation program (9). It is responsible for a long period of sports unavailability, which is a problem, especially in high-level or professional athletes.…”

Section: Introductionmentioning

confidence: 99%

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Return to Sport After Patellar Tendon Rupture:a Systematic Review

Grondin

Garraud

et al. 2019

Muscle Ligaments and Tendons J

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Background. Patellar tendon rupture is a rare and disabling injury that may occur during sport practice and is considered as the 4 th stage of the Blazina's classification of jumper's knee. Return to sport after patellar tendon rupture has not been clearly assessed. Methods. Medical databases were screened, and article research extended from 1980 to April 2019. The inclusion criteria were report of more than 2 cases of isolated and complete uni-or bilateral patellar tendon rupture, patients over 18. Studies that did not specify patients' ability to return to sport were excluded. Results. Nine studies, 196 patients and 202 patellar tendon ruptures were included. Mean follow-up ranged from 24 to 111.5 months and return to sport ranged from 52 to 100%. Crucial data were often lacking, such as the type of sport practiced, the pre-injury level of sport, and the delay of return to sport. A high proportion of patients did not report any medical history that could have weakened their patellar tendon before the rupture. Conclusions. The rate of return to sport seems good but our conclusions are restricted due to the studies' low level of evidence. It highlights the need of a standardized report of specific data.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

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Return to Sport After Patellar Tendon Rupture:a Systematic Review

Grondin

Garraud

et al. 2019

Muscle Ligaments and Tendons J

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“…A recent controlled laboratory animal study suggests that a period of postoperative immobilisation after tendon-to-bone repair may optimise healing, giving less scar tissue and a stronger tendon–bone interface 42. In a thorough systematic review, Serino et al found early postoperative mobilisation to be associated with a significantly higher adverse event rate than late mobilisation, when compared with minimum 6 weeks of immobilisation 43…”

Section: Discussionmentioning

confidence: 99%

Knee sliced open by skate blade: complete patellar tendon rupture in an elite long track speed skater

Tandberg

Grindem

Wiig³

et al. 2019

BMJ Case Rep

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A long track speed skater sustained a deep horizontal cut to the right knee just distally to the patella, after he got hit by the skate blade of the pair mate. The injury included a complete patellar tendon rupture from the apex of the patella, a 1 mm deep transverse cut in the femoral condyle and a partial rupture of the anterior cruciate ligament. The tendon rupture was repaired with transosseous suture repair without augmentation. A knee brace was used for 8 weeks, with a gradual decrease in flexion restraints. A rehabilitation programme was overseen by a dedicated physiotherapist. At 6 months, he started a gradual return to skating sessions. After 1 year, he had symmetrical single-legged hop performance, but quadriceps weakness due to pain. The patient returned to competition speed skating at national levels after 11 months, and within the first postoperative year, he was breaking new personal records on the ice.

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“…Postoperatively, all patients followed the standardized rehabilitation protocols implemented at our institution following extensor mechanism repair. These protocols follow principles similar to those described in the literature, 4,17 which included four phases of weight-bearing activity with a frequency defined as two to three times per week for at least 12 weeks. Phase 1 is defined as the time period of 0 to 2 weeks postoperatively with weight bearing as tolerated in a hinged-knee brace locked in extension.…”

Section: Methodsmentioning

confidence: 99%

Extensor Mechanism Ruptures and Reruptures: Perioperative Opioid Management

et al. 2020

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AbstractThe purpose of this study was to determine (1) the correlation between preoperative and postoperative opioid use and (2) risk factors associated with rerupture in patients undergoing open extensor mechanism repair. A retrospective review of patients who underwent operative repair of quadriceps or patellar tendon rupture was performed. Patients were classified as opioid nonusers if they had not received any opioid medications in the 3 months before surgery, or as acute users or chronic users if they received at least one opioid prescription within 1 month or 3 months preceding surgery. Clinical records were reviewed for postoperative opioid use within a year after surgery as well as rerupture rates. A total of 144 quadriceps tendon and 15 patellar tendon repairs were performed at a mean age of 56.8 ± 15.1 years and body mass index of 33.2 ± 7.1. The overall rerupture rate was 6%. Diabetes was a significant risk factor for rerupture (56 vs. 19%, p = 0.023). Chronic preoperative opioid users were more likely to continue to use opioids beyond 1 month postoperatively (p < 0.001) as compared with acute or nonopioid users. Chronic preoperative opioid users (relative risk [RR]: 3.53, 95% confidence interval [CI]: 2.11–5.90) and patients with longer anesthesia time (RR: 1.39, 95% CI: 1.00–1.93) required more monthly opioid refills, whereas tourniquet use required fewer opioid refills each month (RR: 0.57, 95% CI: 0.37–0.88). Compared with patients without a rerupture, each additional prescription refill after the initial repair in the rerupture group was associated with a 22% higher risk of tendon rerupture (RR: 1.22, 95% CI: 1.07–1.39). The chronicity of preoperative opioid intake was found to have a significant effect on postoperative opioid use. This study suggests that there is a higher prevalence of rerupture in patients with prolonged opioid use postoperatively and among diabetics.

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Comparison of adverse events and postoperative mobilization following knee extensor mechanism rupture repair: A systematic review and network meta-analysis

Cited by 29 publications

References 34 publications

Return to Sport After Patellar Tendon Rupture:a Systematic Review

Return to Sport After Patellar Tendon Rupture:a Systematic Review

Knee sliced open by skate blade: complete patellar tendon rupture in an elite long track speed skater

Extensor Mechanism Ruptures and Reruptures: Perioperative Opioid Management

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