Return to sport after early surgical repair of acute patellar tendon ruptures

Beranger, J; Kajetanek, Charles; Bayoud, Wael; Pascal-Mousselard, H.; Khiami, F.

doi:10.1016/j.otsr.2020.01.010

Cited by 21 publications

(11 citation statements)

References 21 publications

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“…A recent systematic review of 33 studies including 757 patients found an overall rate of return to play of 88.9%, with 80.8% returning to the same level of sports ( 2 ). Age over 40 years and BMI > 25 have been associated with lower rates of RTS ( 29 ).…”

Section: Patellar Tendon Rupturesmentioning

confidence: 99%

Extensor mechanism ruptures

et al. 2022

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Native patellar tendon injuries are seen in younger patients compared to quadriceps tendon ruptures. Up to a third of the patients may have local (antecedent tendinopathy and cortisone injections) or systemic risk factors (obesity, diabetes, hyperparathyroidism, chronic renal failure, fluoroquinolone or statin use) of injury, these are more frequent in bilateral disruptions. Complete extensor mechanism disruptions should be repaired surgically. Although isolated primary repair has been reported to have good outcomes in younger patients with acute tears and good tendon quality, augmentation of the repair with autograft, allograft or synthetic material should be considered in patients with poor tendon quality, chronic tears or tendon defects. High rates of return to work/sports have been reported in native patellar and quadriceps tendon tears, with re-rupture rates <5%. Extensor mechanism disruptions in patients with a total knee arthroplasty are challenging due to older age, systemic co-morbidities and poor local conditions, resulting in inferior outcomes compared to native extensor mechanism injuries. Some form of augmentation with autograft, allograft or synthetics is advisable in all cases. Salvage procedures such as whole extensor mechanism allografts provide acceptable outcomes in multiply operated knees with extensive bone and soft tissue deficits.

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Section: Patellar Tendon Rupturesmentioning

confidence: 99%

Extensor mechanism ruptures

et al. 2022

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“…All patients reached preinjury levels of injury by 6 months and no postoperative complications were reported. Beranger et al 1 reported 94% return to sports, 83% at the same level, 8 to 18 months following patellar tendon repair augmented with a nonmetallic tibiopatellar suture. Kasten et al 3 reported good intermediate to long-term results with average follow-up of 8 years in 2 cohorts, one with reinforcement with a wire cerclage and the other with a polydioxanone cord.…”

Section: Video Transcriptmentioning

confidence: 99%

“…They typically occur in men under 40 years old as a result of eccentric quadriceps contraction while the knee is flexed and the foot is planted. 1 The optimal treatment is surgical repair within 2 weeks of injury to prevent scar formation, degeneration, and loss of tendon excursion.Indications: Operative management is generally indicated for patellar tendon ruptures. In this case, a physically active, healthy 24-year-old man presented with acute pain, extensor lag, and patella alta related to a basketball injury.…”

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confidence: 99%

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Hybrid Knot and Knotless Suture Anchor Repair for Patellar Tendon Rupture

Ezeokoli

Sutton

Shybut

2022

Video Journal of Sports Medicine

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Background: Patellar tendon ruptures are the third-most common injury involving the knee extensor mechanism. They typically occur in men under 40 years old as a result of eccentric quadriceps contraction while the knee is flexed and the foot is planted.1 The optimal treatment is surgical repair within 2 weeks of injury to prevent scar formation, degeneration, and loss of tendon excursion. Indications: Operative management is generally indicated for patellar tendon ruptures. In this case, a physically active, healthy 24-year-old man presented with acute pain, extensor lag, and patella alta related to a basketball injury. He was diagnosed with acute patellar tendon rupture/extensor mechanism disruption and indicated for surgery. Technique description: We describe a technique for primary patellar tendon repair which uses both knot-based and knotless suture anchor fixation. Using a pulley effect, sutures in the inferior patellar anchors are used to reduce and repair the patellar tendon back to its bony origin. Patellar anchor-based tapes and a suprapatellar traction suture are affixed with knotless anchors to the proximal tibia to reinforce the repair. Anchor-based suture limbs are used to repair the medial and lateral retinacula. Results: The senior authors’ experience with this technique has been excellent restoration of extensor mechanism function, with rehabilitation permitting early range of motion and no major complications or failures. This patient returned to unassisted activities of daily living between 8 and 12 weeks and had returned to gym workouts and recreational sports at 12 months. Discussion/conclusion: Biomechanical studies have demonstrated that compared with transosseous repair, suture anchor repair decreases gap formation and improves ultimate load to failure. Advantages of suture anchor repair include smaller incision, less tissue dissection, shorter operative time, and improved repair biomechanics. Our technique follows a principle of tendon repair using a high number of suture and tape limbs to span the repair. In addition, this technique incorporates a “double row” of suture anchors and spans the primary repair with a suture and tape “internal brace.” The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.

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“…Strengthening exercises are then initiated [65,66] . Patients usually return to activities between six and nine months after QT repair and PT repair [66,67] .…”

Section: Tendon Rupturesmentioning

confidence: 99%