Early motion after quadriceps and patellar tendon repairs: outcomes with single-suture augmentation.
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.


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


METHODS
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 degrees 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 degrees to 10 degrees 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.


CONCLUSIONS
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.
West
Jesse L
JL
Division of Sports Medicine, Department of Orthopedic Surgery and Rehabilitation,University of Wisconsin-Madison, Madison, Wisconsin, USA.
Keene
James S
JS
Kaplan
Lee D
LD
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000502:physiology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000502:physiology*; D053580:Muscle Strength / Q000502:physiology; D017847:Patellar Ligament / Q000503:physiopathology / Q000601:surgery*; D016059:Range of Motion, Articular / Q000502:physiology; D012421:Rupture / Q000601:surgery; D013536:Suture Techniques; D013537:Sutures; D013708:Tendon Injuries / Q000503:physiopathology / Q000534:rehabilitation* / Q000601:surgery*; D016896:Treatment Outcome; D016474:Weight-Bearing / Q000502:physiology