Abstract
Rupture of the patellar tendon is an uncommon injury that requires acute surgical
repair to restore the function of the knee. Multiple techniques for repair have been
described in the literature. Complications with these repair techniques include rerupture
and extensor lag caused by gap formation at the site of repair. Thus, many surgeons
have suggested augmenting the standard repair. Several methods of augmentation have
been described each with disadvantages. The purpose of this article was to present
our case series of six patients with acute patella tendon ruptures treated by a novel
procedure using strong sutures. In this method, eight strands of four-strong sutures
run within the tendon. At the patellar site, a combination of suture button and figure
eight pattern techniques is used, avoiding stress concentration. The optimal tension
is applied to each suture, so as the patella might be positioned at the original placement.
Then all sutures are secured onto the tibia. Postoperatively with a mean follow-up
of 32.7 months (range: 25–48 months), all patients had a stable knee with mean flexion
of 143.3 degrees (range: 140–150 degrees) and without any extension lag. With an improvement
in the International Knee Documentation Committee score to 86.8 (range: 80–92), the
excellent outcome was noted in all patients. The average postoperative Lysholm score
was 98.8 (range: 97–100) and the average Kujala score was 95.2 (range: 92–97). All
patients recovered to near-normal strength and stability of the patellar tendon as
well as restoration of function after the operation. This augmentation technique offers
a distinct advantage over previous augmentation methods and materials, and may be
especially useful in managing patellar tendon rupture caused by rheumatoid arthritis
or other systemic conditions. For these reasons, we recommend this procedure for acute
patellar tendon ruptures.
Keywords
patellar tendon rupture - acute - repair - augmentation - strong suture
