Outcomes following quadriceps tendon repair using transosseous tunnels versus suture anchors: A systematic review |
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| Institution: | 1. Penn State University College of Medicine, United States of America;2. Penn State Hershey Medical Center, Department of Orthopaedics, United States of America;1. Department of Clinical & Health Psychology, Leeds Teaching Hospitals NHS Trust, Leeds, UK;2. Academic Department of Trauma and Orthopaedics, Floor D, Clarendon Wing, LGI, University of Leeds, Leeds, UK;3. NIHR Leeds Biomedical Research Center, Chapel Allerton Hospital, Leeds, UK;1. Department of Orthopaedic Surgery, NorthWest Clinics, Alkmaar, the Netherlands;2. Centre for Orthopaedic Research Alkmaar, NorthWest Clinics, Alkmaar, the Netherlands;1. Department of Health Administration, Brooks College of Health, University of North Florida, 1 UNF Drive, Jacksonville, FL 32224, United States;2. College of Applied Sciences, Al Maarefa University, P.O. Box 71666, Riyadh 11597, Saudi Arabia;3. Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada;4. Department of Health Sciences Research, Division of Health Care Policy and Research, College of Medicine, Mayo Clinic Robert D. and Patricia E. Kern, Center for the Science of Health Care Delivery, 4500 San Pablo Road, Jacksonville, FL 32224, United States;1. Department of Orthopaedics, The First Affiliated Hospital of Soochow University, Soochow University, Suzhou 215006, China;2. Orthopaedic Institute, Medical College, Soochow University, Suzhou 215007, China;3. School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario NZL 3G1, Canada;1. Department of Orthopaedic Surgery, General Hospital of Central Theater Command, Wuhan Clinical Medicine College of Southern Medical University, Wuhan, 430070,China;2. Huaiyin hospital of huai an city, Huaian, 223300, China;4. Wuhan University of Technology, Department of Mechanical Room, Wuhan, 430070, China |
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| Abstract: | IntroductionTwo major techniques are used to repair complete quadriceps tendon ruptures, transosseous tunnel (TT) and the suture anchor (SA). There are multiple studies comparing the biomechanical outcomes of repairs performed with TT or SA. Our purpose was to compare the clinical outcomes following quadriceps tendon repair using SA and TT fixation techniques.MethodsThree major search engines were used with predetermined keyword searches to perform a systematic review of literature. These studies were independently scanned by two reviewers using PRISMA criterion. All included studies had to include at least one of the following outcome measures: range of motion (ROM), Lysholm score, complications, and/or re-ruptures.ResultsUsing three major search engines, 1039 articles were identified. After removing duplicates and screening for inclusion, 49 articles were reviewed. Two independent reviewers searched the studies to meet the inclusion criteria, and eight studies were selected. These eight studies included 156 knees in the TT group and 54 knees in the SA group. The TT group had a significantly better ROM after QT repair (132.5° versus 127.0°, p = 0.02). There was no significant difference in Lysholm scores between the TT group (92.6) and SA group (91.0, p = 0.11). There were significantly more complications in SA groups (9.3% versus 1.3%, p = 0.013), but not a significant difference in re-rupture rate between those undergoing SA vs. TT repair (3.7% versus 0%, p = 0.065). The SA group had a significantly higher age at time of surgery (63.62 vs. 54.32)ConclusionThe current study suggests that, following quadriceps tendon rupture, there are no significant differences in functional outcome between TT and SA techniques. Those undergoing TT repair attained a statistically significantly greater final ROM but this difference may not be clinically relevant. There was a statistically significantly higher rate of post-operative complications using SA technique. |
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