title: Patellar tendon rupture repair using Dall-Miles cable.
abstract: Ten patients underwent patellar tendon repair with end-to-end suture technique and medial and lateral retinacular repair, as well as reinforcement with a Dall-Miles cable through the patella and tibial tubercle. The cable was tensioned at 60 degrees of flexion to allow immediate range of motion to at least 100 degrees of flexion and to protect the repair from undue tension while healing. Accurate tendon length was obtained from a lateral radiograph of the noninvolved knee in 60 degrees of flexion. Patients were allowed to bear full weight as tolerated postoperatively. A knee immobilizer was worn for approximately 2 weeks when adequate muscular control of the leg was attained. The cable was removed 6-8 weeks postoperatively, at which time range of motion equal to the opposite extremity was sought. Full extension was obtained by 1 week postoperatively. Average postoperative knee flexion was 88 degrees at 2 weeks, 112 degrees at 1 month, 133 at 3 months, and 138 degrees at 6 months compared to flexion of 141 degrees in the noninvolved knee. Mean quadriceps muscle strength 1 year postoperatively was 72%+/-11% of the noninvolved leg. No patient had patella infera or rerupture after surgery. Repair of a patellar tendon rupture with end-to-end techniques reinforced with a Dall-Miles cable allows immediate rehabilitation without the need for prolonged immobilization. This technique allows restoration of full range of motion early postoperatively and enables patients to regain adequate quadriceps strength.
authors.affiliation: Methodist Sports Medicine Center, Indianapolis, Ind, USA.
authors.forename: K D
authors.initials: KD
authors.lastname: Shelbourne
authors.forename: M P
authors.initials: MP
authors.lastname: Darmelio
authors.forename: T E
authors.initials: TE
authors.lastname: Klootwyk
mesh_terms: D000058:Accidental Falls; D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery; D000070598:Anterior Cruciate Ligament Injuries; D001864:Bone Wires; D004434:Early Ambulation; D006801:Humans; D008875:Middle Aged; D010149:Postoperative Pain / Q000175:diagnosis / Q000209:etiology; D017847:Patellar Ligament / Q000000981:diagnostic imaging / Q000293:injuries* / Q000503:physiopathology / Q000601:surgery* / Q000637:transplantation; D011182:Postoperative Care / Q000379:methods; D011859:Radiography; D016059:Range of Motion, Articular; D012046:Rehabilitation / Q000379:methods; D012421:Rupture; D013165:Splints; D013536:Suture Techniques; D013709:Tendon Transfer / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome; D016474:Weight-Bearing; D014945:Wound Healing