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First published on October 11, 2007, doi:10.1177/0363546507308192
This version was published on February 1, 2008
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The American Journal of Sports Medicine 36:316-323 (2008)
© 2008 American Orthopaedic Society for Sports Medicine

Early Motion After Quadriceps and Patellar Tendon Repairs

Outcomes With Single-Suture Augmentation

Jesse L. West, MD, James S. Keene, MD* and Lee D. Kaplan, MD

From the Division of Sports Medicine, Department of Orthopedic Surgery and Rehabilitation, University of Wisconsin–Madison, Madison, Wisconsin

* Address correspondence to James S. Keene, MD, 600 Highland Ave, Madison, WI 53792 (e-mail: keene{at}orthorehab.wisc.edu).

Background: Complications of immobilization after quadriceps and patellar tendon repairs include decreased patellar mobility, limited flexion, persistent pain, muscle weakness, and patella baja. In contrast, early motion limits muscle atrophy, accelerates tendon healing, and prevents joint stiffness.

Hypothesis: Quadriceps and patellar tendon repairs protected with a "relaxing suture" are strong enough to safely permit early motion, full weightbearing, and brace-free ambulation.

Study Design: Case series; Level of evidence, 4.

Methods: Twenty quadriceps and 30 patellar tendon ruptures were treated with a primary repair augmented with a single No. 5 Ethibond suture, a postoperative regimen of controlled motion and full weightbearing at 7 to 10 days, and brace-free ambulation at 6 weeks after surgery. At a minimum follow-up of 12 months, results of surgery were assessed with the Lysholm knee rating system.

Results: Six weeks after surgery, 120° of flexion and brace-free ambulation were the goals and were achieved at a mean of 7.2 and 7.7 weeks, respectively. By 6 months, all patients reached their preinjury levels of activity (eg, basketball, softball, Rocky Mountain tour guide), 40 had full active extension, and 10 lacked 3° to 10° of active extension. There were no postoperative complications. At a mean follow-up of 4 years (range, 1–12 years), the Lysholm scores averaged 92 points (range, 84–100 points), and there were 35 excellent, 15 good, and no fair or poor results.

Conclusion: Quadriceps and patellar tendon repairs protected by a relaxing suture were strong enough to safely permit early motion, weightbearing, and brace-free ambulation while producing good and excellent results.

Key Words: quadriceps • patellar tendon repairs






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