Combined repair technique for patellar tendon rupture using two suture anchors and three transosseous sutures: a retrospective cohort study.

Background: Patellar tendon rupture is an uncommon injury that usually requires surgical repair, but no consensus exists regarding the ideal repair technique. Suture anchor repair and the transosseous suture method have be widely used, but the suture anchor technique may cause anchor pull-out, while the transosseous suture method may result in insufficient suture strength. Therefore, we propose and evaluate the efficacy of combined repair technique with two suture anchors and three transosseous sutures for patellar tendon repairs.

Methods: We conducted a retrospective cohort study of patients who received surgery for acute patellar tendon rupture at the inferior pole of the patella between January 2016 and December 2020. All patients underwent a standardized integrated knee extensor mechanism combined repair technique by the same surgeon with 2 suture anchors and 3 transosseous sutures. Radiology, complications, and patient-reported outcomes were recorded. Clinical outcomes were measured using range of motion (ROM), patient satisfaction, Visual Analog Scale (VAS) pain scores, Knee Society Function Score (KSS-F), International Knee Documentation Committee (IKDC) score, Lysholm score, and Tegner score.

Results: Totally 40 patients were enrolled with an average age of 33.95 years. Mean follow-up duration was 60 months (range: 36 to 72 months). The risk of complications was 7.5% (3/40). Mean ROM improved from 45.65 ± 10.66 preoperatively to 127.25 ± 3.99 postoperatively (mean ± SD, p < 0.001). Mean postoperative VAS pain score, KSS-F score, IKDC score, Lysholm score and Tegner score significantly improved (p < 0.001). The Caton Deschamps Index (CDI) significantly decreased from 1.74 ± 0.19 preoperatively to 1.11 ± 0.06 postoperatively (p < 0.001). Postoperative MRI revealed evident healing between the patellar tendon and the inferior pole of the patella.

Conclusions: The combined repair technique demonstrated reliable mid-term outcomes with satisfactory functional recovery, radiological healing, and a low complication rate. This technique may serve as a practical and effective option for proximal patellar tendon ruptures.