Penn State University College of Medicine, United States of America.
Penn State University College of Medicine, United States of America.
Injury. 2021 Mar;52(3):339-344. doi: 10.1016/j.injury.2020.10.020. Epub 2020 Oct 5.
Two major techniques are used to repair complete quadriceps tendon ruptures, transosseous tunnel (TT) and the suture anchor (SA). There are multiple studies comparing the biomechanical outcomes of repairs performed with TT or SA. Our purpose was to compare the clinical outcomes following quadriceps tendon repair using SA and TT fixation techniques.
Three major search engines were used with predetermined keyword searches to perform a systematic review of literature. These studies were independently scanned by two reviewers using PRISMA criterion. All included studies had to include at least one of the following outcome measures: range of motion (ROM), Lysholm score, complications, and/or re-ruptures.
Using three major search engines, 1039 articles were identified. After removing duplicates and screening for inclusion, 49 articles were reviewed. Two independent reviewers searched the studies to meet the inclusion criteria, and eight studies were selected. These eight studies included 156 knees in the TT group and 54 knees in the SA group. The TT group had a significantly better ROM after QT repair (132.5° versus 127.0°, p = 0.02). There was no significant difference in Lysholm scores between the TT group (92.6) and SA group (91.0, p = 0.11). There were significantly more complications in SA groups (9.3% versus 1.3%, p = 0.013), but not a significant difference in re-rupture rate between those undergoing SA vs. TT repair (3.7% versus 0%, p = 0.065). The SA group had a significantly higher age at time of surgery (63.62 vs. 54.32) CONCLUSION: The current study suggests that, following quadriceps tendon rupture, there are no significant differences in functional outcome between TT and SA techniques. Those undergoing TT repair attained a statistically significantly greater final ROM but this difference may not be clinically relevant. There was a statistically significantly higher rate of post-operative complications using SA technique.
修复完全四头肌腱断裂有两种主要技术，即经骨隧道（TT）和缝线锚（SA）。有多项研究比较了 TT 或 SA 修复的生物力学结果。我们的目的是比较使用 SA 和 TT 固定技术修复四头肌腱后临床结果。
使用三个主要搜索引擎，通过预定的关键词搜索，对文献进行系统综述。这些研究由两位评审员使用 PRISMA 标准独立扫描。所有纳入的研究必须包括以下至少一项结果测量：活动范围（ROM）、Lysholm 评分、并发症和/或再断裂。
使用三个主要搜索引擎，共确定了 1039 篇文章。在去除重复项并进行纳入筛选后，共审查了 49 篇文章。两位独立评审员搜索研究以满足纳入标准，共选择了 8 项研究。这 8 项研究中 TT 组包括 156 个膝关节，SA 组包括 54 个膝关节。在四头肌腱修复后，TT 组的 ROM 明显更好（132.5°比 127.0°，p=0.02）。TT 组和 SA 组的 Lysholm 评分无显著差异（92.6 与 91.0，p=0.11）。SA 组并发症明显更多（9.3%比 1.3%，p=0.013），但 SA 组与 TT 组再断裂率无显著差异（3.7%比 0%，p=0.065）。SA 组的手术时年龄明显更高（63.62 比 54.32）。
本研究表明，在四头肌腱断裂后，TT 和 SA 技术在功能结果方面没有显著差异。接受 TT 修复的患者达到了统计学上更大的最终 ROM，但这种差异可能在临床上没有意义。使用 SA 技术的术后并发症发生率明显更高。
