Comparative outcomes of trans-osseous tunnels versus suture anchors reinsertion for the treatment of acute quadriceps tendon rupture.

Abstract

Quadriceps tendon rupture is a rare disabling injury, predominantly affecting older males. Prompt surgical intervention is essential to restore knee extensor mechanism. Patellar trans-osseous tunnels technique is considered the treatment of choice, however recently suture anchors technique is suggested as a comparative method to restore the integrity of the quadriceps tendon. This study aimed to compare patient-reported outcomes, operative times, and complication rates between trans-osseous tunnel and suture anchor fixation techniques for acute quadriceps tendon rupture. A retrospective, IRB-approved cohort study was conducted at an academic level I trauma center. Eighty-five patients who underwent surgical repair for acute quadriceps tendon rupture using either trans-osseous tunnels (n=46) or suture anchors (n=39) were included, with one-year follow-up. Demographic, clinical, and surgical data were extracted from electronic medical records. Patient-reported outcome measures (PROMs) assessed at one year included the International Knee Documentation Committee (IKDC) score, Lysholm score, and Visual Analog Scale (VAS) for pain. Operative times and complications were also analyzed. There were no significant differences in age or gender distribution between groups. The anchor group demonstrated a significantly shorter mean operative time. At one-year follow-up, no statistically significant differences were observed in PROMs: IKDC, and VAS. Complication rates were similar between groups, with two fixation failures (anchor group) and two infections (one per group), all managed successfully. Both trans-osseous tunnel and suture anchor techniques yield comparable functional outcomes and complication rates in the surgical management of acute quadriceps tendon rupture. Suture anchors offer reduced operative time significantly.