Augmented Tendon Repair with Internal Bracing: Surgical Technique

Objectives: The role of internal bracing in lower limb tendon repairs and reconstructions is not widely published. We report our techniques for internal brace-augmented tendon repair (IBA-TR) in the surgical treatment of acute ruptures of the patellar tendon, the quadriceps tendon and the Achilles tendon. Methods: The outcomes of 100 cases of IBA-TR treated by a single surgeon over an 8-year period (2014-2022) were retrospectively analysed with a minimum follow-up of 6 months. Results: The mean time to mobilisation without a brace was 32 days. Three cases of infection were reported and treated with antibiotics, with no cases of deep infection requiring return to theatre. There were no cases of venous thromboembolism. No cases of failure of tendon repair were observed. Of the 100 patients, 98 returned to their pre-injury level of activity. Conclusions: This study represents the largest cohort of tendon repairs augmented with an internal brace to date. With no reported failures or returns to theatre, this repair technique has been demonstrated to be safe and clinically effective, dispensing with the need for cast immobilisation. Level of evidence: III.