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Barber FA. Editorial Commentary: Quadriceps Tendon Suture Anchor Repair Provides Better Patient-Reported Outcomes Than Transosseous Tunnel Repair: Defining the New Gold Standard. Arthroscopy 2023; 39:1490-1492. [PMID: 37147076 DOI: 10.1016/j.arthro.2023.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 01/07/2023] [Indexed: 05/07/2023]
Abstract
Quadriceps tendon suture anchor repair provides biomechanically greater and more consistent failure loads than transosseous tunnel repair, including less cyclic displacement (gap formation). Although satisfactory clinical outcomes are found with both repair techniques, few studies provide a side-to-side comparison. However, recent research demonstrates better clinical outcomes in using suture anchors, with equal failure rates. Suture anchor repair is minimally invasive requiring smaller incisions, less patellar dissection, and eliminates patellar tunnel drilling that can breach the anterior cortex, create stress risers, result in osteolysis from nonabsorbable intraosseous sutures and longitudinal patellar fractures. Suture anchor quadriceps tendon repair should now be considered the gold standard.
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Sasaki R, Nagashima M, Aibara N, Aomatsu S, Aida S, Takeshima K, Ishii K. Simultaneous bilateral quadriceps tendon rupture in a healthy young male: a case report. J Med Case Rep 2023; 17:85. [PMID: 36879269 PMCID: PMC9990254 DOI: 10.1186/s13256-023-03802-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 02/01/2023] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND Simultaneous bilateral quadriceps tendon rupture is rare, particularly in young individuals with no prior medical history. We present the case of a young man who presented with bilateral quadriceps tendon rupture. CASE PRESENTATION A 27-year-old Japanese man missed a step while descending a flight of stairs, stumbled, and became aware of severe pain in both knees. He had no past medical history, but was severely obese, with a body mass index of 43.7 kg/m2 (height 177 cm, weight 137 kg). Five days after injury, he was referred to our hospital for examination and treatment. Bilateral quadriceps tendon rupture was diagnosed based on magnetic resonance imaging, and quadriceps tendon repair with suture anchor was performed on both knees 14 days after injury. The postoperative rehabilitation protocol was to immobilize both knees in extension for 2 weeks, then to gradually proceed with weight-bearing and gait training using hinged knee braces. Both knees obtained a range of motion from 0° to 130° without any extension lag by 3 months postoperatively. One year postoperatively, tenderness was evident at the suture anchor in the right knee. That suture anchor was therefore removed in a second operation, and histological evaluation of the tendon of the right knee revealed no pathological changes. As of 19 months after the primary surgery, the patient showed a range of motion from 0° to 140° in both knees, did not complain of any disability, and had fully returned to normal daily activities. CONCLUSIONS We experienced simultaneous bilateral quadriceps tendon rupture in a 27-year-old man with no past medical history other than obesity. Suture anchor repair was performed for both quadriceps tendon ruptures and achieved a favorable postoperative outcome.
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Affiliation(s)
- Ryo Sasaki
- Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, 4-3 Kōzunomori, Narita City, Chiba, 286-8686, Japan.,Department of Orthopaedic Surgery, International University of Health and Welfare Mita Hospital, 1-4-3 Mita, Minato-ku, Tokyo, 108-8329, Japan.,Department of Orthopaedic Surgery, International University of Health and Welfare Narita Hospital, 852 Hatakeda, Narita City, Chiba, 286-8520, Japan
| | - Masaki Nagashima
- Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, 4-3 Kōzunomori, Narita City, Chiba, 286-8686, Japan. .,Department of Orthopaedic Surgery, International University of Health and Welfare Mita Hospital, 1-4-3 Mita, Minato-ku, Tokyo, 108-8329, Japan. .,Department of Orthopaedic Surgery, International University of Health and Welfare Narita Hospital, 852 Hatakeda, Narita City, Chiba, 286-8520, Japan.
| | - Noriyuki Aibara
- Department of Orthopaedic Surgery, International University of Health and Welfare Mita Hospital, 1-4-3 Mita, Minato-ku, Tokyo, 108-8329, Japan
| | - Shuji Aomatsu
- Department of Orthopaedic Surgery, International University of Health and Welfare Mita Hospital, 1-4-3 Mita, Minato-ku, Tokyo, 108-8329, Japan
| | - Shinsuke Aida
- Department of Pathology, International University of Health and Welfare Mita Hospital, 1-4-3 Mita, Minato-ku, Tokyo, 108-8329, Japan
| | - Kenichiro Takeshima
- Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, 4-3 Kōzunomori, Narita City, Chiba, 286-8686, Japan.,Department of Orthopaedic Surgery, International University of Health and Welfare Narita Hospital, 852 Hatakeda, Narita City, Chiba, 286-8520, Japan
| | - Ken Ishii
- Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, 4-3 Kōzunomori, Narita City, Chiba, 286-8686, Japan.,Department of Orthopaedic Surgery, International University of Health and Welfare Mita Hospital, 1-4-3 Mita, Minato-ku, Tokyo, 108-8329, Japan.,Department of Orthopaedic Surgery, International University of Health and Welfare Narita Hospital, 852 Hatakeda, Narita City, Chiba, 286-8520, Japan
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Zengui ZF, El Adaoui O, Fargouch M, Okouango BJC, El Andaloussi Y, Fadili M. Quadriceps tendon repair using double row suture anchor fixation: Case reports and review of the literature. Int J Surg Case Rep 2022; 92:106838. [PMID: 35202938 PMCID: PMC8881491 DOI: 10.1016/j.ijscr.2022.106838] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 02/11/2022] [Accepted: 02/13/2022] [Indexed: 12/04/2022] Open
Abstract
Introduction Traumatic rupture of the quadricipital tendon is rare and disabling. The traditional repair technique involving transpatellar tunnels is still relevant, but this technique seems to be superseded for the technique using anchors. This study aimed to present the place of the anchors in quadriceps tendon tears, and assess the functional results after a means follow-up of 18.66 months. Case reports We report 03 cases of acute rupture of the quadricipital tendon collected in the Trauma Surgery and Orthopaedics Department. The average age was 53.66 years, all patients were male, the rupture occurred after a sporting accident in one case, and in 2 cases concerning minimal trauma from a fall in 2 patients followed for renal failure. The average consultation time was 48 h. The right knee was affected in 2. The clinical presentation was identical in all patients with the deficit of active extension of the leg. All patients were treated surgically with the use of double row anchors. The technique used consisted of insertion of two 5.0 mm anchors at the base of the patella, and the proximal part of the quadricipital tendon was sutured with heavy absorbable sutures using Krakow suture. Results At a mean follow-up of 18.66 months, no infectious complications were noted, no active extension deficit and the active flexion average was 123.33°. Conclusion The rupture of the quadricipital tendon is a rare injury. Surgical treatment by double row anchors gives excellent results with a satisfactory medium-term functional recovery and allow early rehabilitation. Quadriceps tendon ruptures are rare and compromise the knee's extension mechanism. The surgical traditional technique consisted of reinsertion of the quadricipital tendon by transosseous stitches. Surgical repair with suture anchors has been shown to have decreased gap formation and increased ultimate loads to failure.
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Affiliation(s)
- Z F Zengui
- Department of Trauma Surgery and Orthopaedics, Ibn Rochd University Hospital Center, Casablanca, Morocco; Faculty of Medicine and Pharmacy of Casablanca, Hassan II University, Morocco.
| | - O El Adaoui
- Department of Trauma Surgery and Orthopaedics, Ibn Rochd University Hospital Center, Casablanca, Morocco; Faculty of Medicine and Pharmacy of Casablanca, Hassan II University, Morocco
| | - M Fargouch
- Department of Trauma Surgery and Orthopaedics, Ibn Rochd University Hospital Center, Casablanca, Morocco; Faculty of Medicine and Pharmacy of Casablanca, Hassan II University, Morocco
| | - B J C Okouango
- Department of Trauma Surgery and Orthopaedics, Ibn Rochd University Hospital Center, Casablanca, Morocco; Faculty of Medicine and Pharmacy of Casablanca, Hassan II University, Morocco
| | - Y El Andaloussi
- Department of Trauma Surgery and Orthopaedics, Ibn Rochd University Hospital Center, Casablanca, Morocco; Faculty of Medicine and Pharmacy of Casablanca, Hassan II University, Morocco
| | - M Fadili
- Department of Trauma Surgery and Orthopaedics, Ibn Rochd University Hospital Center, Casablanca, Morocco; Faculty of Medicine and Pharmacy of Casablanca, Hassan II University, Morocco
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