Repair of patellar tendon disruptions without hardware.
Acute repair of disruptions of the knee extensor mechanism is indicated to reestablish extensor continuity and allow for early motion. This study reviews the results of acute primary repair of patellar tendon ruptures augmented by a nonabsorbable polyester tape (Mersilene; Ethicon, Inc.) followed by immediate mobilization. Twenty-four patients with disruptions of their patellar tendons were treated using the described technique. The ruptured tendon was initially approximated using an end-to-end suture repair with no. 5 Ticron suture in a whipstitch manner. An O Vicryl suture was used to approximate the free tendon edges. A 5-mm Mersilene tape was then used in a cerclage manner to augment and protect the repair. Postsurgery, passive range of motion (ROM) was begun immediately in the knees with isolated injury or in those patients whose concomitant injuries would allow for early motion. Using clinical and radiographic criteria, follow-up evaluations of 19 patients were performed at an average of 22.4 months. In patients with isolated injuries, active ROM was from 0 degrees extension to 132 degrees flexion (contralateral knee 0-135 degrees). Two patients had prominent knots: in one, the knots were painful and were removed surgically. Six patients developed patellofemoral chondrosis. Five patients had the Mersilene tape tied with the knee in full extension, and all developed patellofemoral pain. The other repairs were done with the knee flexed to 90 degrees before tying; one patient in this group developed patellofemoral symptoms. All patients with isolated injuries have returned to employment. There were no reruptures or infections.(ABSTRACT TRUNCATED AT 250 WORDS)
Lindy
P B
PB
Department of Orthopaedic Surgery, Brown University School of Medicine, Providence, Rhode Island 02903, USA.
Boynton
M D
MD
Fadale
P D
PD
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000534:rehabilitation / Q000601:surgery; D008297:Male; D008875:Middle Aged; D017847:Patellar Ligament / Q000293:injuries* / Q000601:surgery*; D011091:Polyesters / Q000627:therapeutic use; D019736:Prostheses and Implants; D016059:Range of Motion, Articular; D012421:Rupture; D013536:Suture Techniques
D011091:Polyesters