Prospective multicentre study of the clinical and functional outcomes following quadriceps tendon repair with suture anchors

Mille, F.; Adam, Antoine; Aubry, S.; Leclerc, Grégoire; Ghislandi, X.; Sergent, P; Garbuio, P.

doi:10.1007/s00590-015-1710-6

Cited by 33 publications

(44 citation statements)

References 34 publications

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“…Mean Lysholm Scores [ 14 ] achieved by both groups were comparable to previously published results. [ 6 , 9 , 20 , 21 ] Although a difference of 6 points in mean Lysholm Score between the groups (SA: 88, TS: 94) was recorded, statistical analysis revealed this was not significant. The mean Tegner Activity Score of the TS group was slightly higher than that of the SA group (5 vs. 4).…”

Section: Discussionmentioning

confidence: 91%

“…To date, few cases of SA repair for ruptured quadriceps tendons have been published, all showing comparable outcomes to TS repair. [ 5 , 6 , 7 , 8 , 9 ] Recent cadaveric studies have attested the biomechanical superiority of suture anchor repair. [ 10 , 11 ] Several advantages of SA repair over TS repair have been suggested in literature including biomechanical superiority allowing for early functional rehabilitation.…”

Section: Introductionmentioning

confidence: 99%

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Clinical outcomes after treatment of quadriceps tendon ruptures show equal results independent of suture anchor or transosseus repair technique used – A pilot study

et al. 2018

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Biomechanical studies have shown the use of suture anchors (SA) to be superior to the traditional transosseous sutures (TS) in the repair of quadriceps tendon rupture (QTR). This study aimed to analyze and compare the functional outcomes of patients treated for quadriceps tendon ruptures using suture anchors or transosseous sutures. Patients having undergone suture anchor repair or transosseous suture repair for quadriceps tendon rupture between 2010 and 2015 at one of the two participating hospitals were included. Patients from site A underwent TS repair (TS group) while patients from site B underwent SA repair (SA group). Exclusion criteria included previous or concomitant injuries of the involved knee, penetrating injuries and pre-existing neurological conditions. Clinical outcome was assessed by subjective scores (Lysholm and Tegner Scores, International Knee Documentation Committee (IKDC) Score, Visual Analog Scale (VAS) for pain), quadriceps isokinetic strength testing, Insall-Salvati Index (ISI), and physical examination. Non-parametrical statistical analysis was conducted using the Mann-Whitney U test. Twenty-seven patients were included in the study of which 17 patients (63%) were available for follow-up (SA group: 9, TS group: 8). All patients were male with a mean age of 62.7 (SD: 8.8) and 57.9 (SD: 12.7) years for the SA group and TS group, respectively. The groups did not differ in terms of demographic characteristics. No clinically significant differences were identified between the two groups. There were no re-ruptures in either group. Treatment of quadriceps tendon rupture using suture anchors provides a clinically valid alternative treatment to the gold-standard transosseous suture repair.

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Section: Discussionmentioning

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Clinical outcomes after treatment of quadriceps tendon ruptures show equal results independent of suture anchor or transosseus repair technique used – A pilot study

et al. 2018

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“…17,18 Functional outcomes comparing suture anchor and transosseous tunnel repair for quadriceps tendon ruptures have been shown to be equivalent. 19 Published studies on quadriceps repair have tended to show no significant difference between the two techniques, nonstandardization in suture type, number, and configuration within each study have led to questions of scientific validity due to significant confounding variables. 8,[20][21][22][23] As compared with transosseous techniques, a suture anchor technique for patellar tendon repair offers the possibility of decreased tissue trauma, given the need to dissect only the distal pole of the patella.…”

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confidence: 99%

Biomechanical Evaluation of Suture Anchor versus Transosseous Tunnel Patellar Tendon Repair Techniques

et al. 2018

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The objective of this study is to compare the cyclic loading strength and ultimate failure load in suture anchor repair versus transosseous tunnel repair of patellar tendons using a cadaver model. Twelve cadaveric patella specimens were used (six matched pairs). Dual-energy X-ray absorptiometry (DXA) measurements were performed to ensure equal bone quality among groups. All right knees were assigned to the suture anchor repair group ( = 6), whereas all left knees were assigned to the transosseous bone tunnel group ( = 6). Suture type and repair configuration were equivalent. After the respective procedures were performed, each patella was mounted into a gripping jig. Tensile load was applied at a rate of 1 Hz between magnitudes of 50 and 150 N, 50 and 200 N, 50 and 250 N, and tensile load at a rate of 0.1 mm/s until failure. Failure was defined as a sharp deviation in the linear load versus displacement curve, and failure mode was recorded. DXA measurements demonstrated equivalence of bone quality between the two groups ( > 0.05). During cyclic load testing, there was only a statistically significant difference between the groups with regard to cyclic loading at the 50 to 200 N loading cycle ( = 0.010). There was no statistically significant difference between the groups with regard to ultimate load to failure ( = 0.43). Failure mode within the suture anchor cohort occurred through anchor pullout except for one, which failed through the tendon. All specimens within the transosseous cohort failed through the midsubstance of the tendon except for one, which failed through suture breakage. Suture anchor repair demonstrated a similar biomechanical profile regarding cyclic loading and ultimate load to failure when compared with "gold standard" transosseous tunnel patellar tendon repair with a trend toward less gapping in the suture anchor group. Using suture anchors for repair of the patella tendon has similar biomechanical properties to transpatellar tunnels but may provide other clinical advantages.

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“…This did to a certain extent correlate with previous findings(1), stating a 2% postoperative re-rupture risk. The included re-ruptures in the anchor fixation group, were excluded by Mille et al (28) due to that the two cases were considered technical failures. These two patients did not wear the splint as instructed.…”

Section: Discussionmentioning

confidence: 99%

“…consisted of 81 patients from 4 studies(13,(28)(29)(30). A total of 81 QTRs were reported with 78 patients available for follow-up.…”

mentioning

confidence: 99%

Quadriceps tendon rupture. Anchor or transosseous suture? A systematic review

Hochheim

Bartels

Iversen

2019

Muscle Ligaments and Tendons J

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Introduction. When dealing with ruptures at the tendon-bone junction either transosseous sutures(TS) or anchor fixation(AF) are the most well described methods of repair. The aim of this study was to compare these two surgical methods by carrying out a systematic review of the existing literature. Methods. A systematic search of bibliographic databases to identify studies using either TS or AF for patients with QTR, with outcome measures being either range of motion(ROM), extension lag(EL), re-rupture(RR) and/or Lysholm score(LS). Results. The AF group included 3 studies containing 45 patients. The postoperative outcomes reported were a ROM average of 128,5°, and 3 EL (6,7%) and 2 RR were reported(4,4%). 2 postoperative LS showed an average of 88,9. The TS group included 2 studies containing 32 patients. One study reported an average ROM postoperatively of 138°, one a ROM under 120° postoperatively in 2 out of 14 QTRs, 3 EL (13%), no RR and one postoperative LS of 94 in 8 patients. Conclusion. This study implies a slight postoperative advantage when using transosseous sutures compared to anchor fixation. However, given a low patient count and a lack of statistical power, no conclusion on the optimal surgical method for QTR can be made.

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Prospective multicentre study of the clinical and functional outcomes following quadriceps tendon repair with suture anchors

Abstract: The procedure is simpler when only suture anchors are used. Tendon healing was observed on MRI in all cases. This simple, reproducible technique is free of the drawbacks associated with the typical repair augmentation.

Cited by 33 publications

References 34 publications

Clinical outcomes after treatment of quadriceps tendon ruptures show equal results independent of suture anchor or transosseus repair technique used – A pilot study

Clinical outcomes after treatment of quadriceps tendon ruptures show equal results independent of suture anchor or transosseus repair technique used – A pilot study

Biomechanical Evaluation of Suture Anchor versus Transosseous Tunnel Patellar Tendon Repair Techniques

Quadriceps tendon rupture. Anchor or transosseous suture? A systematic review

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