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International Orthopaedics

, Volume 34, Issue 8, pp 1153–1158 | Cite as

Repair of fresh patellar tendon rupture: tension regulation at the suture line

  • Elsayed Ibraheem Elsayed Massoud
Original Paper

Abstract

The reported complications of the repaired patellar tendon have been attributed to the influence of the mechanical environment on the healing process. This study postulates that the healing complications can be minimised through tension regulation at the suture line using an absorbable reinforcement device. Twelve patients with fresh patellar tendon rupture were included in the study. They were prospectively followed up for an average period of 45 months. The patients resumed their pre-injury activities at an average of 6.1 months. The active knee movement averaged 0–154.6° compared to 0–156.7° in the contralateral knee. Radiologically no patella alta, patella baja or degenerative changes in the patellofemoral joints were noted. The results support use of the absorbable reinforcement device for tension regulation at the suture line.

Keywords

Patellar Tendon Patellofemoral Joint Reinforcement Device Patellar Height Tension Regulation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Aspenberg P (2007) Stimulation of tendon repair: mechanical loading, GDFs and platelets. A mini-review. Int Orthop 31:783–789PubMedCrossRefGoogle Scholar
  2. 2.
    Blackburne JS, Peel TE (1977) A new method of measuring patella height. J Bone Joint Surg Br 59:241–242PubMedGoogle Scholar
  3. 3.
    Bourne RB, Bitar H, Andreae PR et al (1988) In-vivo comparison of four absorbable sutures: Vicryl, Dexon Plus, Maxon and PDS. Can J Surg 31(1):43–45PubMedGoogle Scholar
  4. 4.
    Buckwalter JA, Cruess RL (1991) Healing of the musculoskeletal tissues. In: Rockwood CA Jr, Green DP (eds) Fractures in adults. J.B. Lippincott, Philadelphia, pp 203–205Google Scholar
  5. 5.
    Greenwald D, Shumway S, Albear P, Gottlieb L (1994) Mechanical comparison of 10 suture materials before and after in vivo incubation. J Surg Res 56(4):372–377PubMedCrossRefGoogle Scholar
  6. 6.
    Hibino N, Hamada Y, Sairyo K et al (2007) Callus formation during healing of the repaired tendon-bone junction. A rat experimental model. J Bone Joint Surg Br 89:1539–1544PubMedCrossRefGoogle Scholar
  7. 7.
    In Y, Kim SJ, Kwon YJ (2007) Patellar tendon lengthening for patella infera using the Ilizarov technique. J Bone Joint Surg Br 89(3):398–400PubMedCrossRefGoogle Scholar
  8. 8.
    Insall J, Salvati E (1971) Patella position in the normal knee joint. Radiology 101:101–104PubMedGoogle Scholar
  9. 9.
    Kader D, Saxena A, Movin T, Maffulli N (2002) Achilles tendinopathy: some aspects of basic science and clinical management. Br J Sports Med 36:239–249PubMedCrossRefGoogle Scholar
  10. 10.
    Larson RV, Simonian PT (1995) Semitendinosus augmentation of acute patellar tendon repair with immediate mobilization. Am J Sports Med 23:82–86PubMedCrossRefGoogle Scholar
  11. 11.
    Lindy PB, Boynton MD, Fadale PD (1995) Repair of patellar tendon disruptions without hardware. J Orthop Trauma 9:238–243PubMedCrossRefGoogle Scholar
  12. 12.
    Lysholm J, Gillquist J (1982) Evaluation of knee ligament surgery results with special emphasis on use of a scoring scale. Am J Sports Med 10:150–154PubMedCrossRefGoogle Scholar
  13. 13.
    Maffulli N (1999) Rupture of the Achilles tendon. J Bone Joint Surg Am 81:1019–1036PubMedGoogle Scholar
  14. 14.
    Marder RA, Swanson TV, Sharkey NA, Duwelius PJ (1993) Effects of partial patellectomy and reattachment of the patellar tendon on patellofemoral contact areas and pressures. J Bone Joint Surg Am 75:35–45PubMedGoogle Scholar
  15. 15.
    Marder RA, Timmerman LA (1999) Primary repair of patellar tendon rupture without augmentation. Am J Sports Med 27(3):304–307PubMedGoogle Scholar
  16. 16.
    Nebelung W, Becker R, Urbach D, Röpke M, Roessner A (2003) Histological findings of tendon-bone healing following anterior cruciate ligament reconstruction with hamstring grafts. Arch Orthop Trauma Surg 123:158–163PubMedGoogle Scholar
  17. 17.
    Newsham-West R, Nicholson H, Walton M, Milburn P (2007) Long-term morphology of a healing bone-tendon interface: a histological observation in the sheep model. J Anat 210:318–327PubMedCrossRefGoogle Scholar
  18. 18.
    Rodeo SA, Arnoczky SP, Torzilli PA, Hidaka C, Warren RF (1993) Tendon-healing in a bone tunnel. A biomechanical and histological study in the dog. J Bone Joint Surg Am 75:1795–1803PubMedGoogle Scholar
  19. 19.
    Scott WN, Insall JN (1991) Extensor mechanism injuries. In: Rockwood CA Jr, Green DP (eds) Fractures in adults. J.B. Lippincott, Philadelphia, pp 1816–1839Google Scholar
  20. 20.
    Singha BI, Sinhaa S, Singha S, Shrivastavaa R, Mandaliab VI (2004) Stress fracture patella following patella tendon repair. Injury Extra 35:13–16CrossRefGoogle Scholar
  21. 21.
    Siwek CW, Rao JP (1981) Ruptures of the extensor mechanism of the knee joint. J Bone Joint Surg Am 63:932–937PubMedGoogle Scholar
  22. 22.
    Ward SR, Terk MR, Powers CM (2007) Patella alta: association with patellofemoral alignment and changes in contact area during weight-bearing. J Bone Joint Surg Am 89:1749–1755PubMedCrossRefGoogle Scholar
  23. 23.
    Yildirim Y, Saygi B, Kara H, Cabukoğlu C, Esemenli T (2006) Tendon holding capacities of the suture materials used in repairing Achilles tendon rupture (in Turkish). Acta Orthop Traumatol Turc 40(2):164–168PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  1. 1.Orthopaedic DepartmentSohag Teaching Hospital, General Organization for Teaching Hospitals and InstitutesSohagEgypt

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