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Midterm outcome and strength assessment after quadriceps tendon refixation with suture anchors

PURPOSE: Quadriceps tendon ruptures (QTR) occur predominantly in middle-aged patients through violent eccentric contraction that occurs either when trying to regain balance or during a fall on the hyperflexed knee. The aim of this study was to quantify midterm postoperative results, including streng...

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Autores principales: Geyer, Stephanie, Winden, Felix, Braunsperger, Alexander, Kreuzpointner, Florian, Kleim, Benjamin D., Lappen, Sebastian, Imhoff, Andreas B., Mehl, Julian, Hinz, Maximilian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Paris 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10125935/
https://www.ncbi.nlm.nih.gov/pubmed/35137251
http://dx.doi.org/10.1007/s00590-022-03218-x
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author Geyer, Stephanie
Winden, Felix
Braunsperger, Alexander
Kreuzpointner, Florian
Kleim, Benjamin D.
Lappen, Sebastian
Imhoff, Andreas B.
Mehl, Julian
Hinz, Maximilian
author_facet Geyer, Stephanie
Winden, Felix
Braunsperger, Alexander
Kreuzpointner, Florian
Kleim, Benjamin D.
Lappen, Sebastian
Imhoff, Andreas B.
Mehl, Julian
Hinz, Maximilian
author_sort Geyer, Stephanie
collection PubMed
description PURPOSE: Quadriceps tendon ruptures (QTR) occur predominantly in middle-aged patients through violent eccentric contraction that occurs either when trying to regain balance or during a fall on the hyperflexed knee. The aim of this study was to quantify midterm postoperative results, including strength potential measured via standardized strength tests following acute (< six weeks) quadriceps tendon refixation using suture anchors. METHODS: All consecutive patients with QTR who underwent surgical suture anchor refixation between 2012 and 2019 at a single institution with a minimum follow-up of 12 months were retrospectively evaluated. Outcome measures included Tegner Activity Scale (TAS), Lysholm score, International Knee Documentation Committee subjective knee form (IKDC), Knee injury and Osteoarthritis Outcome Score (KOOS) subscales, return to work rates, and Visual Analog Scale (VAS) for pain. Additionally, a standardized clinical examination and an isometric strength assessment of knee extension and flexion were performed. RESULTS: A total of 17 patients (median age 61.0 [25–75% IQR 50.5–72.5]) were available for final assessment at a mean follow-up of 47.1 ± SD 25.4 months. The majority of patients were male (82.4%) and most injuries occurred due to a fall on the hyperflexed knee (76.5%). The average time interval between trauma and surgery was 12.7 ± 7.5 days. Patients achieved a moderate level of activity postoperatively with a median TAS of 4 (3–5.5) and reported good to excellent outcome scores (Lysholm score: 97 (86.5–100); IKDC: 80.7 ± 13.5; KOOS subscales: pain 97.2 (93.1–100), symptoms 92.9 (82.5–100), activities of daily living 97.1 (93.4–100), sport and recreation function 80 (40–97.5) and knee-related quality of life 87.5 (62.5–100). All patients were able to fully return to work and reported little pain [VAS: 0 (0–0)]. No postoperative complications were reported. Strength measurements revealed a significant deficit of knee extension strength in comparison to the contralateral side (p = 0.011). CONCLUSION: Suture anchor refixation of acute QTR leads to good functional results and high patient satisfaction without major complications. Isometric knee extension strength, however, may not be fully restored compared to the unaffected side.
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spelling pubmed-101259352023-04-26 Midterm outcome and strength assessment after quadriceps tendon refixation with suture anchors Geyer, Stephanie Winden, Felix Braunsperger, Alexander Kreuzpointner, Florian Kleim, Benjamin D. Lappen, Sebastian Imhoff, Andreas B. Mehl, Julian Hinz, Maximilian Eur J Orthop Surg Traumatol Original Article PURPOSE: Quadriceps tendon ruptures (QTR) occur predominantly in middle-aged patients through violent eccentric contraction that occurs either when trying to regain balance or during a fall on the hyperflexed knee. The aim of this study was to quantify midterm postoperative results, including strength potential measured via standardized strength tests following acute (< six weeks) quadriceps tendon refixation using suture anchors. METHODS: All consecutive patients with QTR who underwent surgical suture anchor refixation between 2012 and 2019 at a single institution with a minimum follow-up of 12 months were retrospectively evaluated. Outcome measures included Tegner Activity Scale (TAS), Lysholm score, International Knee Documentation Committee subjective knee form (IKDC), Knee injury and Osteoarthritis Outcome Score (KOOS) subscales, return to work rates, and Visual Analog Scale (VAS) for pain. Additionally, a standardized clinical examination and an isometric strength assessment of knee extension and flexion were performed. RESULTS: A total of 17 patients (median age 61.0 [25–75% IQR 50.5–72.5]) were available for final assessment at a mean follow-up of 47.1 ± SD 25.4 months. The majority of patients were male (82.4%) and most injuries occurred due to a fall on the hyperflexed knee (76.5%). The average time interval between trauma and surgery was 12.7 ± 7.5 days. Patients achieved a moderate level of activity postoperatively with a median TAS of 4 (3–5.5) and reported good to excellent outcome scores (Lysholm score: 97 (86.5–100); IKDC: 80.7 ± 13.5; KOOS subscales: pain 97.2 (93.1–100), symptoms 92.9 (82.5–100), activities of daily living 97.1 (93.4–100), sport and recreation function 80 (40–97.5) and knee-related quality of life 87.5 (62.5–100). All patients were able to fully return to work and reported little pain [VAS: 0 (0–0)]. No postoperative complications were reported. Strength measurements revealed a significant deficit of knee extension strength in comparison to the contralateral side (p = 0.011). CONCLUSION: Suture anchor refixation of acute QTR leads to good functional results and high patient satisfaction without major complications. Isometric knee extension strength, however, may not be fully restored compared to the unaffected side. Springer Paris 2022-02-09 2023 /pmc/articles/PMC10125935/ /pubmed/35137251 http://dx.doi.org/10.1007/s00590-022-03218-x Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Article
Geyer, Stephanie
Winden, Felix
Braunsperger, Alexander
Kreuzpointner, Florian
Kleim, Benjamin D.
Lappen, Sebastian
Imhoff, Andreas B.
Mehl, Julian
Hinz, Maximilian
Midterm outcome and strength assessment after quadriceps tendon refixation with suture anchors
title Midterm outcome and strength assessment after quadriceps tendon refixation with suture anchors
title_full Midterm outcome and strength assessment after quadriceps tendon refixation with suture anchors
title_fullStr Midterm outcome and strength assessment after quadriceps tendon refixation with suture anchors
title_full_unstemmed Midterm outcome and strength assessment after quadriceps tendon refixation with suture anchors
title_short Midterm outcome and strength assessment after quadriceps tendon refixation with suture anchors
title_sort midterm outcome and strength assessment after quadriceps tendon refixation with suture anchors
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10125935/
https://www.ncbi.nlm.nih.gov/pubmed/35137251
http://dx.doi.org/10.1007/s00590-022-03218-x
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