Quadriceps Tendon Tear Rupture in Healthy Patients Treated with Patellar Drilling Holes: Clinical and Ultrasonographic Analysis After 36 Months of Follow-up

Overview

Journal Muscles Ligaments Tendons J

Date 2014 Oct 22

PMID 25332935

Citations 4

Authors

Michele Arcangelo Verdano

Matteo Zanelli

Davide Aliani

Tiziana Corsini

Andrea Pellegrini

Francesco Ceccarelli

Affiliations

Soon will be listed here.

Abstract

Background: quadriceps tendon subcutaneous rupture is an uncommon injury affecting predominantly middle-aged men as a result of direct or indirect trauma; aim of this work is to evaluate clinical outcome and tendon morphology in patients treated surgically with transpatellar drilling suture.

Methods: 20 patients (20 male) with an average age of 54 (42-59) were evaluated with a mean follow-up of 36 months. Measurements of range of motion (ROM) and of tight circumference were collected. Lysholm and Rougraff Score were also performed. All the patients underwent a US evaluation the morphologic changes of the repaired tendon.

Results: mean active ROM was 1°-117°; average difference in the circumference of the quadriceps was 2.6% 10 C and 3.3% 15 C. The mean Lysholm Score calculated was 88/100; the mean Rougraff Score 17/25. At ultrasonographic evaluation all tendons were continuous; heterotopic ossification was present in 18 quadriceps tendons. Thickness was augmented in 18 quadriceps tendons and in 5 patellar tendons. Vascularization was always conserved. Lateral subluxation of patella was reported in 1 case.

Conclusions: patellar drilling holes repair is a non-demanding procedure, inexpensive and technically uncomplicated. US evaluation confirms tendon healing; tendon remodeling does not affect patient's clinical outcome and quality of life.

Level Of Incidence: IV.

Citing Articles

Coladonato C, Perez A, Sonnier J, Looney A, Delvadia B, Okhuereigbe D Arthrosc Sports Med Rehabil. 2023; 5(6):100807.

PMID: 37868659 PMC: 10585628. DOI: 10.1016/j.asmr.2023.100807.

Successful Surgical Repair of Acute Quadriceps Tendon Rupture Utilizing Cortical Button Fixation: A Case Report.

Bae A, Collins D, Jardaly A, Fernicola P Am J Case Rep. 2021; 22:e934238.

PMID: 34937853 PMC: 8713079. DOI: 10.12659/AJCR.934238.

Outcomes after quadriceps tendon repair in patients over 80 years of age.

Ellanti P, Moriarty A, Nagle M, McCarthy T Muscles Ligaments Tendons J. 2016; 6(2):224-227.

PMID: 27900296 PMC: 5115254. DOI: 10.11138/mltj/2016.6.2.224.

Association between patella spurs and quadriceps tendon ruptures.

Ellanti P, Moriarity A, Wainberg N, Ni Fhoghlu C, McCarthy T Muscles Ligaments Tendons J. 2015; 5(2):88-91.

PMID: 26261786 PMC: 4496023.

References

Kannus P, Jozsa L . Histopathological changes preceding spontaneous rupture of a tendon. A controlled study of 891 patients. J Bone Joint Surg Am. 1991; 73(10):1507-25. View

Richards D, Barber F . Repair of quadriceps tendon ruptures using suture anchors. Arthroscopy. 2002; 18(5):556-9. DOI: 10.1053/jars.2002.30729. View

Siwek C, Rao J . Ruptures of the extensor mechanism of the knee joint. J Bone Joint Surg Am. 1981; 63(6):932-7. View

Larsen E, Lund P . Ruptures of the extensor mechanism of the knee joint. Clinical results and patellofemoral articulation. Clin Orthop Relat Res. 1986; (213):150-3. View

Konrath G, Chen D, Lock T, Goitz H, Watson J, Moed B . Outcomes following repair of quadriceps tendon ruptures. J Orthop Trauma. 1998; 12(4):273-9. DOI: 10.1097/00005131-199805000-00010. View

Shah M . Simultaneous bilateral rupture of quadriceps tendons: analysis of risk factors and associations. South Med J. 2002; 95(8):860-6. View

Lighthart W, Cohen D, Levine R, Parks B, Boucher H . Suture anchor versus suture through tunnel fixation for quadriceps tendon rupture: a biomechanical study. Orthopedics. 2009; 31(5):441. DOI: 10.3928/01477447-20080501-18. View

Wenzl M, Kirchner R, Seide K, Strametz S, Jurgens C . Quadriceps tendon ruptures-is there a complete functional restitution?. Injury. 2004; 35(9):922-6. DOI: 10.1016/S0020-1383(03)00261-4. View

Rougraff B, Reeck C, Essenmacher J . Complete quadriceps tendon ruptures. Orthopedics. 1996; 19(6):509-14. View

10.

Khaliq Y, Zhanel G . Musculoskeletal injury associated with fluoroquinolone antibiotics. Clin Plast Surg. 2005; 32(4):495-502, vi. DOI: 10.1016/j.cps.2005.05.004. View

11.

Puranik G, Faraj A . Outcome of quadriceps tendon repair. Acta Orthop Belg. 2006; 72(2):176-8. View

12.

Ciriello V, Gudipati S, Tosounidis T, Soucacos P, Giannoudis P . Clinical outcomes after repair of quadriceps tendon rupture: a systematic review. Injury. 2012; 43(11):1931-8. DOI: 10.1016/j.injury.2012.08.044. View

13.

Vidil A, Ouaknine M, Anract P, Tomeno B . [Trauma-induced tears of the quadriceps tendon: 47 cases]. Rev Chir Orthop Reparatrice Appar Mot. 2004; 90(1):40-8. DOI: 10.1016/s0035-1040(04)70005-7. View

14.

West J, Keene J, Kaplan L . Early motion after quadriceps and patellar tendon repairs: outcomes with single-suture augmentation. Am J Sports Med. 2007; 36(2):316-23. DOI: 10.1177/0363546507308192. View

15.

Maniscalco P, Bertone C, Rivera F, Bocchi L . A new method of repair for quadriceps tendon ruptures. A case report. Panminerva Med. 2001; 42(3):223-5. View

16.

Hart N, Wallace M, Scovell J, Krupp R, Cook C, Wyland D . Quadriceps tendon rupture: a biomechanical comparison of transosseous equivalent double-row suture anchor versus transosseous tunnel repair. J Knee Surg. 2012; 25(4):335-9. DOI: 10.1055/s-0031-1299656. View

17.

Rasul Jr A, Fischer D . Primary repair of quadriceps tendon ruptures. Results of treatment. Clin Orthop Relat Res. 1993; (289):205-7. View

18.

Ramseier L, Werner C, Heinzelmann M . Quadriceps and patellar tendon rupture. Injury. 2006; 37(6):516-9. DOI: 10.1016/j.injury.2005.12.014. View

19.

Vainionpaa S, Bostman O, Patiala H, Rokkanen P . Rupture of the quadriceps tendon. Acta Orthop Scand. 1985; 56(5):433-5. DOI: 10.3109/17453678508994366. View

20.

Bushnell B, Whitener G, Rubright J, Creighton R, Logel K, Wood M . The use of suture anchors to repair the ruptured quadriceps tendon. J Orthop Trauma. 2007; 21(6):407-13. DOI: 10.1097/BOT.0b013e31806dd93b. View