Smaller Gap Formation With Suture Anchor Fixation Than Traditional Transpatellar Sutures in Patella and Quadriceps Tendon Rupture: A Systematic Review

Onggo, James Randolph; Babazadeh, Sina; Pai, Vishal

doi:10.1016/j.arthro.2022.01.012

Cited by 15 publications

(9 citation statements)

References 50 publications

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“…46 However, another recent systematic review reported smaller gap formations after both quadriceps and PT ruptures in suture anchor fixation compared with transosseous tunnel technique. 47 Mehta et al reported improved ROM and lower complication rates for transosseous tunnel technique, and similar Lysholm scores and re-rupture rates in a systematic review. 45 In our study, we found no difference between any techniques for re-rupture and complication rates.…”

Section: Discussionmentioning

confidence: 82%

Do Patellar Tendon Repairs Have Better Outcomes than Quadriceps Tendon Repairs? A Prospective Cohort Analysis

et al. 2022

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Patellar tendon (PT) and quadriceps tendon (QT) ruptures represent significant injuries and warrant surgical intervention in most patients. Outcome data are predominantly retrospective analyses with low sample sizes. There are also minimal data comparing QT and PT repairs and the variables impacting patient outcomes. The level of evidence of the study is level II (prognosis). From the prospective OME cohort, 189 PT or QT repairs were performed between February 2015 and October 2019. Of these, 178 were successfully enrolled (94.2%) with 1-year follow-up on 141 (79.2%). Baseline demographic data included age, sex, race, BMI, years of education, smoking status, and baseline VR-12 MCS score. Surgical and follow-up data included surgeon volume, fixation technique, baseline, and 1-year Knee Injury and Osteoarthritis Outcome Score-Pain (KOOS-Pain), Knee Injury and Osteoarthritis Outcome Score—Physical Function (KOOS-PS), and 1-year Patient Acceptable Symptom State (PASS) scores and complications. Multivariable regression analysis was utilized to identify prognosis and significant risk factors for outcomes—specifically, whether KOOS-Pain or KOOS-PS were different between QT versus PT repairs. There were 59 patients in the PT cohort and 82 patients in QT cohort. Baseline demographic data demonstrated that PT cohort was younger (45.1 vs. 59.5 years, p <0.001), included significantly fewer patients of White race (51.7 vs. 80.0%, p = 0.001), lesser number of years of education (13.9 vs. 15.2 years, p = 0.020), a higher percentage of “high” surgeon volume (72.9% vs. 43.9%, p = 0.001) and 25.4% of PT repairs had supplemental fixation (QT had zero, p <0.001). Multivariable analysis identified gender (female-worse, p = 0.001), years of education (higher-better, p = 0.02), and baseline KOOS-Pain score (higher-better, p <0.001) as the risk factors that significantly predicted KOOS-Pain score. The risk factors that significantly predicted KOOS-PS were gender (female worse, p = 0.033), race (non-White-worse, p <0.001), baseline VR-12 MCS score (higher-better, p <0.001), and baseline KOOS-PS score (higher better, p = 0.029). KOOS-Pain and KOOS-PS scores improved after both QT and PT repairs. Patient reported pain and function at 1 year were similar between PT and QT repairs after adjusting for known risk factors. Multivariable analysis identified female gender and low baseline KOOS scores as predictors for worse outcomes.

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Section: Discussionmentioning

confidence: 82%

Do Patellar Tendon Repairs Have Better Outcomes than Quadriceps Tendon Repairs? A Prospective Cohort Analysis

et al. 2022

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“…However, in studies related to patellar and quadriceps tendon repair, suture anchors showed superior mechanical properties compared to transosseous sutures. 14 In addition, there was also a study that the suture anchor may be better even in the presence of osteoporosis. 15 Therefore, our method may show higher stability than transosseous sutures.…”

Section: Discussionmentioning

confidence: 99%

A novel technique of tibial tuberosity fracture fixation with two knotless suture anchors in an adult: A case report and literature review

Choi

Park

2022

AOTT

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Tibial tuberosity fractures are uncommon in adults. Surgery for these types of fractures is performed similarly to that of tibial tuberosity avulsion fractures in adolescents. The most commonly introduced method is to fix the displaced bone fragments using screws or wires and, if necessary, use tension band wiring for augmentation. However, if the bone fragments are too small or severely comminuted, it may be challenging to fix them using the conventional method. In this study, we introduced a fixation method using two knotless suture anchors that could be attempted in such cases. Since this surgical method fixes the bone fragments without direct damage to the bone fragments, it can be used even when the fragments are small or comminuted. This technique achieved a nearly full active range of knee motion without an extension lag at four weeks postoperatively. In addition, there were no complications related to surgery, and a complete bone union was achieved without additional dislocation. Therefore, this surgical method may be a good alternative if a fixation of the fracture is considered problematic by the conventional method.

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“…In a separate meta-analysis, suture anchors again demonstrated favorable biomechanical properties in terms of gap formation when compared with transosseous tunnels. 55 The authors also found most suture anchor failures were in cases of titanium anchors.…”

Section: Complete Thickness Rupturementioning

confidence: 94%

Acute Patellar Tendon Ruptures: An Update on Management

Brinkman,

Reeson,

Chhabra

2024

JAAOS Glob Res Rev

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Patellar tendon ruptures can be debilitating injuries. When incomplete, partial tears can be managed nonsurgically with immobilization and progressive rehabilitation. Although complete ruptures remain a relatively uncommon injury, they portend a high level of morbidity. Ruptures typically result from an acute mechanical overload to the extensor mechanism, such as with forced quadriceps contraction and knee flexion. However, chronically degenerated tendons are also predisposed to failure from low-energy injuries. Diagnosis can often be made clinically with recognition of a palpable defect to the tendon, localized patellar tendon tenderness, and inability to actively extend the knee. Diagnosis and surgical planning can be established with radiograph, ultrasonography, or magnetic resonance imaging. Surgical repair is the mainstay of treatment, and there have been many recent advances in repair technique, optimal reconstruction strategies, and supplemental fixation. Time to surgery for complete tears remains the most important prognosticator for success. Direct primary repair can be completed with transosseous tunnels, suture anchor repair, or end-to-end repair. Tendon reconstruction can be achieved with or without mechanical or biologic augments. Rehabilitation programs vary in specifics, but return to sport can be expected by 6 months postoperatively.

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Smaller Gap Formation With Suture Anchor Fixation Than Traditional Transpatellar Sutures in Patella and Quadriceps Tendon Rupture: A Systematic Review

Cited by 15 publications

References 50 publications

Do Patellar Tendon Repairs Have Better Outcomes than Quadriceps Tendon Repairs? A Prospective Cohort Analysis

Do Patellar Tendon Repairs Have Better Outcomes than Quadriceps Tendon Repairs? A Prospective Cohort Analysis

A novel technique of tibial tuberosity fracture fixation with two knotless suture anchors in an adult: A case report and literature review

Acute Patellar Tendon Ruptures: An Update on Management

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