Autograft Augmentation of Patellar Tendon Rupture Allows Better Functional Outcomes and Less Reoperation Than Steel...

Area of Science:

• Orthopedic surgery
• Sports medicine
• Biomaterials science

Background:

• Patellar tendon rupture significantly impacts knee function, often occurring during sports with eccentric quadriceps loading.
• Traditional steel wire cerclage repair has drawbacks like hardware irritation and stiffness, necessitating secondary removal.
• Hamstring tendon autograft augmentation presents a biological alternative to mitigate hardware-related issues and potentially improve healing.

Purpose of the Study:

• To compare functional outcomes, knee motion, and complication rates between hamstring tendon autograft augmentation and steel wire cerclage for acute patellar tendon rupture.
• To evaluate the impact of each surgical technique on reoperation rates and return to preinjury activities.

Main Methods:

• Retrospective multicenter cohort study of 81 patients with isolated patellar tendon rupture or inferior pole patellar avulsion.
• Patients underwent either hamstring tendon autograft augmentation (n=43) or steel wire cerclage (n=38).
• Primary outcome: Lysholm Knee Score; Secondary outcomes: KOOS, UCLA Scale, Forgotten Joint Score-12, range of motion, return to sport/work, complications, reoperations, and patellar height. Minimum follow-up: 24 months.

Main Results:

• Hamstring autograft augmentation showed significantly higher Lysholm and KOOS scores, and greater knee flexion compared to steel wire cerclage.
• Autograft group had fewer complications (7.0% vs 28.9%) and markedly reduced reoperations (7.0% vs 71.1%) due to avoidance of hardware removal.
• Return to preinjury sport was higher in the autograft group (82.8% vs 54.5%), with similar low rerupture rates.

Conclusions:

• Hamstring tendon autograft augmentation provides superior functional recovery, improved knee motion, and a higher rate of return to sport after acute patellar tendon rupture.
• This technique leads to fewer complications and significantly reduces the need for reoperations compared to steel wire cerclage.
• Autograft augmentation is a preferable reinforcement strategy for active patients, offering comparable safety regarding rerupture risk.