Sasaki Ryo, Nagashima Masaki, Otani Toshiro, Okada Yoshifumi, Aida Shinsuke, Takeshima Kenichiro, Ishii Ken
Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, Narita City, Japan.
Department of Orthopaedic Surgery, International University of Health and Welfare, Mita Hospital, Tokyo, Japan.
Arthrosc Sports Med Rehabil. 2021 Oct 28;3(6):e1931-e1936. doi: 10.1016/j.asmr.2021.09.012. eCollection 2021 Dec.
To investigate clinical outcomes over 2 years in cases of quadriceps tendon rupture (QTR) that were surgically treated using fully threaded knotless anchors.
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.
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.
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.
探讨采用全螺纹无结锚钉手术治疗股四头肌肌腱断裂(QTR)2年以上的临床疗效。
纳入2017年11月至2019年1月在我院采用全螺纹无结锚钉修复的4例男性QTR患者的4个膝关节。手术时患者平均年龄为65.3岁(范围:61 - 70岁)。术中通过将膝关节屈曲至90°确认缝合部位的稳定性。术后第7天开始使用伸直位矫形器进行全负重行走。对所有患者评估手术结果、股四头肌肌腱断裂的病理情况及术后临床疗效。
3例为完全性QTR,1例为部分性QTR。平均手术时间为58.5(范围:49 - 74)分钟。病理评估显示2例股四头肌肌腱有透明变性伴肉芽形成。未发生感染和再断裂等并发症。术后1年进行的磁共振成像证实修复的肌腱完全愈合。平均随访期为35.5个月(范围:24 - 46个月)。所有患者均无膝关节伸直滞后,末次随访时Lysholm评分平均为95.3(范围:85 - 100),平均屈曲范围为141.3°(范围:140 - 145°)。
所有病例临床疗效良好,包括2例有病理退行性改变的病例。采用全螺纹无结锚钉的缝合锚钉修复可被认为是一种微创且有效的QTR治疗方法,具有足够强度以允许早期康复。