Matthies Norah-Faye, Paul Ryan A, Dwyer Tim, Chahal Jaskarndip, Whelan Daniel
University of Toronto Orthopaedic Sports Medicine, Toronto, Ontario, Canada.
University of Toronto Orthopaedic Sports Medicine, Women's College Hospital, University of Toronto, and University Health Network, Toronto, Ontario, Canada.
Orthop J Sports Med. 2022 Mar 30;10(3):23259671211045399. doi: 10.1177/23259671211045399. eCollection 2022 Mar.
To date, little clinical evidence exists to support a specific surgical technique or postoperative rehabilitation protocol for quadriceps tendon ruptures. With a lack of evidence-based superiority, assessment of clinical practices and surgeon preferences is pertinent.
To describe the current surgical technique and rehabilitation preferences among members of the Canadian Orthopaedic Association and American Orthopaedic Society for Sports Medicine pertaining to acute quadriceps tendon rupture.
Cross-sectional study.
Orthopaedic staff members of the Canadian Orthopaedic Association and American Orthopaedic Society for Sports Medicine were invited to complete an internet-based survey composed of 26 questions assessing current trends in the management and rehabilitation of acute quadriceps tendon rupture. Survey questions were developed after a thorough review of current literature. Survey responses were analyzed and reported using descriptive statistics (absolute values, frequencies, and percentages) where appropriate. Statistical comparisons and contrasts between Canadian and American surgeons were made using chi-square analyses and Student tests.
A total of 264 surgeons participated in the survey (136 Canadians; 128 Americans). Canadian surgeons were more likely to obtain a preoperative ultrasound as compared with Americans (43.0% vs 6.7%; < .00001), while American respondents were more likely to obtain magnetic resonance imaging scans (65.8% vs 10.2%; < .00001). The transosseous drill hole technique was the most commonly utilized (70.2%); the suture anchor technique was used 20.6% of the time. Canadian respondents trended toward a higher use of transosseous tunnels; however, this was not statistically significant (75.8% vs 64.2%; = .068). American respondents were more likely to utilize suture anchors (27.5% vs 14.1%; = .0096). Most respondents advanced range of motion goals stepwise in 2-week intervals of 30° (Canadians, 54.0% vs Americans, 58.5%; = .3091); timing of range of motion initiation varied.
Among North American surgeons who responded to this study, the transosseous technique was the most commonly used, and range of motion was generally advanced in a 2-week stepwise fashion. We found several differences in practice between Canadian and American respondents, including the type of preoperative imaging and the frequency of using the suture anchor technique.
迄今为止，几乎没有临床证据支持针对股四头肌肌腱断裂的特定手术技术或术后康复方案。由于缺乏基于证据的优势，对临床实践和外科医生偏好进行评估是有必要的。
描述加拿大骨科协会和美国运动医学骨科协会成员中有关急性股四头肌肌腱断裂的当前手术技术和康复偏好。
横断面研究。
邀请加拿大骨科协会和美国运动医学骨科协会的骨科工作人员完成一项基于网络的调查，该调查由26个问题组成，评估急性股四头肌肌腱断裂的管理和康复的当前趋势。在全面回顾当前文献后制定了调查问题。在适当情况下，使用描述性统计（绝对值、频率和百分比）对调查回复进行分析和报告。使用卡方分析和学生t检验对加拿大和美国外科医生进行统计比较和对比。
共有264名外科医生参与了调查（136名加拿大人；128名美国人）。与美国人相比，加拿大外科医生更有可能在术前进行超声检查（43.0%对6.7%；P<.00001），而美国受访者更有可能进行磁共振成像扫描（65.8%对10.2%；P<.00001）。经骨钻孔技术是最常用的（70.2%）；缝线锚钉技术使用了20.6%的时间。加拿大受访者倾向于更高频率地使用经骨隧道；然而，这在统计学上并不显著（75.8%对64.2%；P=.068）。美国受访者更有可能使用缝线锚钉（27.5%对14.1%；P=.0096）。大多数受访者以30°的2周间隔逐步推进活动度目标（加拿大人为54.0%，美国人为58.5%；P=.3091）；开始活动度训练的时间各不相同。
在回应本研究的北美外科医生中，经骨技术是最常用的，活动度通常以2周的逐步方式推进。我们发现加拿大和美国受访者在实践中有一些差异，包括术前成像类型和使用缝线锚钉技术的频率。
