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Primary Repair of Patellar Tendon Rupture Without Augmentation

Richard A. Marder, MD and Laura A. Timmerman, MD

Department of Orthopaedics, University of California at Davis, Sacramento, California

Presented at the 23rd annual meeting of the AOSSM, Sun Valley, Idaho, June 1997.

Address correspondence and reprint requests to Richard A. Marder, MD, University of California at Davis, Department of Orthopaedics, 4860 Y Street, Suite 3800, Sacramento, CA 95817

Repair of patellar tendon ruptures has often relied on cerclage augmentation and prolonged immobilization in extension. We are reporting our experience with avulsion injuries as well as midsubstance ruptures, both treated with primary repair without augmentation, allowing early mobilization in the athlete less than 40 years of age. Repairs were performed to allow knee flexion to more than 60°. Rehabilitation was performed with heel slides, allowing flexion to 45° for the first 3 weeks, increasing to 90° at 3 to 6 weeks, and thereafter without restriction. An accelerated weightbearing and muscle strengthening program was adopted. At a mean follow-up of 2.6 years (range, 20 to 61 months), 12 patients had returned to their previous levels of activity. No loss of extension or extensor lag was noted; mean flexion loss was 5°. Patellofemoral symptoms and signs were present in five patients, but activity was limited in only two. Mean peak torque at 60 deg/sec was 92% (range, 73% to 105%). Mean Lysholm score was 94 ± 2.5 points. Primary repair with immediate, protected range of motion resulted in uniformly excellent results and obviated the need for manipulation or subsequent hardware removal.

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