Outcomes of Quadriceps and Patellar Tendon Repairs Augmented With Polyester Tapes

Rupture of the quadriceps tendon and patellar tendon (QT/PT) is an infrequent injury that displays a bimodal distribution, typically in low-energy injuries in elderly patients and sporting injuries in younger patients. Independent risk factors for QT/PT rupture include renal failure, obesity, steroid or antibiotic use, old age, and diabetes. Prompt repair restores the mobility of the extensor mechanism of the leg and failure can lead to significant morbidity. Augmenting QT/PT repair with polyester tapes could assist in improving the strength of the repair. The purpose of this study was to assess the outcomes of QT/PT repair augmentation with polyester tape.

A single-centre retrospective cohort analysis was conducted during the period from January 2016 to December 2023 on patients who underwent QT/PT rupture repairs augmented with polyester tapes. Data collected included the mechanism of injury, associated risk factors, unilateral or bilateral injuries, time to surgery, complications, range of movements, outcomes, and the duration of follow-up. Operative outcomes were recorded as poor, satisfactory, good, or excellent and depended on the patient's range of movement, ability to weight bear, return to pre-trauma level of fitness, and need for revision. Multiple regression analysis was performed to assess the influence of risk factors on the incidence of QT/PT rupture.

Over the seven-year period, 76% (n = 69; quadriceps tendon (QT) = 22, patellar tendon (PT) = 43, and bilateral = 4) of patients with QT/PT repairs augmented with polyester tapes met the inclusion criteria. The most common mechanisms of injury were a fall downstairs (n = 52) and a twisting injury in sports (n = 11). The average postoperative follow-up was 10 months. A total of 88% achieved excellent (n = 45) and good (n = 11) outcomes following QT/PT repair, and five patients failed to attend follow-up. Having more than two significant risk factors (p < 0.05) and a high impact mechanism (p < 0.05) of injury were the most significant predictors for poor functional outcomes. Of the eight patients with poor outcomes, six had two or more risk factors. All four patients (three with infection and one with PT laxity) who underwent further surgery had two or more risk factors.

Augmenting QT/PT repairs with polyester tapes did not have any adverse effects and is associated with good to excellent outcomes. Risk factors for QT/PT ruptures are also associated with postoperative complications and poor outcomes.