Department of Sports Orthopaedics, Technical University of Munich, Ismaninger Straße 22, 81675, Munich, Germany.
Department of Sport and Health Sciences, Prevention Center, Technical University of Munich, Munich, Germany.
Eur J Orthop Surg Traumatol. 2023 Dec;33(8):3569-3576. doi: 10.1007/s00590-023-03572-4. Epub 2023 May 26.
Patellar tendon ruptures (PTR) occur predominantly in middle-aged patients following indirect trauma. The aim of this study was to quantify the short-term results using a suture tape augmentation technique for the repair of PTR.
All consecutive patients with acute (< 6 weeks) PTR who underwent suture tape augmentation between 03/2014 and 11/2019 at a single institution with a minimum follow-up of 12 months were retrospectively evaluated. Outcome measures included Visual Analog Scale (VAS) for pain, Tegner Activity Scale (TAS) and return to sport rates, Lysholm score, International Knee Documentation Committee subjective knee form (IKDC) as well as Knee Injury and Osteoarthritis Outcome Score (KOOS). Additionally, a standardized clinical examination and an isometric strength evaluation of knee extension and flexion were performed. It was hypothesized that high return to sport rates and good functional outcome would be observed and that the majority of patients would not present with a severe (> 20%) knee extension strength deficit when compared to the contralateral side.
A total of 7 patients (mean age 37.0 ± SD 13.5 years; 6 male/1 female) were available for final assessment at a median follow-up of 17.0 (25-75% IQR 16.0-77.0) months. Three injuries occurred during ball sports, two injuries occurred during winter sports, and one injury each occurred during a motorcycling and skateboarding accident. The average time between trauma and surgery was 4.7 ± 2.6 days. At follow-up, patients reported little pain (VAS: 0 [0-0.4]). Return to sport was possible for all patients 8.9 ± 4.0 months postoperatively at a high level (TAS: 7.0 [6.0-7.0]). Five patients (71.4%) returned to the preinjury level of play, and 2 (28.6%) did not return to the preinjury level of play. Patient-reported outcome measures were moderate to good (Lysholm score: 80.4 ± 14.5; IKDC: 84.2 ± 10.6; KOOS subscales: pain 95.6 ± 6.0, symptoms 81.1 [64.9-89.1], activities of daily living 98.5 [94.1-100], sport and recreation function 82.9 ± 14.1 and knee-related quality of life 75.9 ± 16.3). All patients were very satisfied (57.1%) or satisfied (42.9%) with the postoperative result. No postoperative complications were reported. Strength measurements revealed a severe knee extension deficit in 3 patients (42.9%), but no significant deficit of isometric knee extension or flexion strength in comparison with the contralateral side was observed overall (p > 0.05).
Suture tape augmentation in acute PTR repair leads to good functional outcome without major complications. Although a severe knee extension strength deficit may occur in some patients postoperatively, an excellent return to sports rate and high patient satisfaction can be expected nonetheless.
Retrospective cohort study; III.
髌腱断裂（PTR）主要发生在中年患者，通常是由间接创伤引起的。本研究的目的是使用缝线带增强技术来量化 PTR 修复的短期结果。
回顾性分析了 2014 年 3 月至 2019 年 11 月在一家机构因急性（<6 周）PTR 接受缝线带增强修复的所有连续患者，随访时间至少为 12 个月。主要结果包括视觉模拟评分（VAS）疼痛、Tegner 活动评分（TAS）和重返运动率、Lysholm 评分、国际膝关节文献委员会主观膝关节评分（IKDC）和膝关节损伤和骨关节炎结局评分（KOOS）。此外，还进行了标准化的临床检查和等长膝关节伸展和屈曲的力量评估。假设会观察到高的重返运动率和良好的功能结果，并且与对侧相比，大多数患者不会出现严重的（>20%）膝关节伸展力量缺陷。
共有 7 名患者（平均年龄 37.0±13.5 岁；6 名男性/1 名女性）在中位数为 17.0（25-75% IQR 16.0-77.0）个月的最终评估时可进行随访。3 例损伤发生在球类运动中，2 例损伤发生在冬季运动中，1 例分别发生在摩托车和滑板事故中。受伤与手术之间的平均时间为 4.7±2.6 天。在随访时，患者报告疼痛轻微（VAS：0[0-0.4]）。所有患者术后 8.9±4.0 个月即可重返高水平运动（TAS：7.0[6.0-7.0]）。5 名患者（71.4%）能够恢复到受伤前的运动水平，2 名患者（28.6%）无法恢复到受伤前的运动水平。患者报告的结果测量值为中等至良好（Lysholm 评分：80.4±14.5；IKDC：84.2±10.6；KOOS 亚量表：疼痛 95.6±6.0、症状 81.1[64.9-89.1]、日常生活活动 98.5[94.1-100]、运动和娱乐功能 82.9±14.1 和膝关节相关生活质量 75.9±16.3）。所有患者对术后结果非常满意（57.1%）或满意（42.9%）。无术后并发症报告。力量测量显示 3 名患者（42.9%）存在严重的膝关节伸展缺陷，但总体上与对侧相比，等长膝关节伸展或屈曲力量无明显缺陷（p>0.05）。
缝线带增强在急性 PTR 修复中可导致良好的功能结果，无重大并发症。尽管术后一些患者可能会出现严重的膝关节伸展力量缺陷，但仍可预期有较高的重返运动率和患者满意度。
回顾性队列研究；III 级。
