Suture Anchor Repair With Fully Threaded Knotless Anchors for Quadriceps Tendon Rupture Resulted in Favorable Outcomes After 2 Years

Abstract

Purpose To investigate clinical outcomes over 2 years in cases of quadriceps tendon rupture (QTR) that were surgically treated using fully threaded knotless anchors. Methods A total of four knees in four male patients with QTR repaired with fully threaded knotless anchors at our hospital from November 2017 to January 2019 were enrolled. Mean patient age at surgery was 65.3 years (range: 61-70 years). Intraoperatively, stability of the sutured site was confirmed by knee flexion to 90°. Full weight walking with the orthosis in extension was commenced on the seventh postoperative day. Surgical findings, pathologies of the ruptured quadriceps tendons, and postoperative clinical outcomes were evaluated in all patients. Results The QTR was complete in three cases and partial in one. Average surgical duration was 58.5 (range: 49–74) minutes. Pathological evaluation revealed hyaline degeneration with granulation of the quadriceps tendon in two cases. No complications, such as infection and rerupture, occurred. Magnetic resonance imaging performed 1 year postoperatively confirmed complete healing of the repaired tendon. The mean follow-up period was 35.5 months (range: 24–46 months). None of the patients had extension lag of the knee, and mean Lysholm score and range of flexion were 95.3 (range: 85–100) and 141.3° (range: 140–145°), respectively, at the final follow-up. Conclusions Clinical outcomes were favorable in all cases, including two cases with pathological degenerative changes. Suture anchor repair with fully threaded knotless anchors can be considered a minimally invasive and effective method for QTR, with sufficient strength to allow early rehabilitation.

Simultaneous bilateral quadriceps tendon rupture in a healthy young male: a case report

“…In addition, medical histories of comorbidities have been reported as risk factors for QTR [ 5 ]. Some studies showed that ruptured tendons usually demonstrate pathological changes, such as hypoxic degeneration, mucoid degeneration, endolipomatosis, and other types of degeneration [ 4 , 11 ].…”

“…A recent cadaveric study reported no statistically significant difference in the ultimate load to failure between SA repair and reattaching the tendon through bone tunnels [ 18 , 19 ]. Clinical studies have reported successful outcomes from SA repair [ 4 ]. Given such findings, we performed SA repair in this case, and achieved favorable clinical outcomes.…”

“…QTR requires surgical repair to avoid poor outcomes previously reported in cases of neglected or chronic rupture [ 2 , 3 ]. Suture anchor (SA) repair for QTR is reported to be minimally invasive and simple in cases where the rupture site is near the patella and enables strong suturing [ 4 ]. Previous reports have identified medical histories of comorbidities, such as renal failure, rheumatoid arthritis, systemic lupus erythematosus, and hyperparathyroidism, and the use of oral steroids as risk factors for QTR [ 5 ].…”