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. 2022 May 18;10(5):23259671221097107.
doi: 10.1177/23259671221097107. eCollection 2022 May.

Outcomes After Repair of Quadriceps Tendon Rupture in Patients Aged 40 Years and Younger

Somnath Rao  1 , Emma E Johnson  1 , Taylor D'Amore  1 , Stanley Szeto  1 , Peters Otlans  1 , Steven B Cohen  1
Affiliations

Outcomes After Repair of Quadriceps Tendon Rupture in Patients Aged 40 Years and Younger

Somnath Rao et al. Orthop J Sports Med. .

Abstract

Background: Injury to the quadriceps tendon is rare and most commonly occurs in middle-aged men. Few reports are available regarding outcomes after quadriceps tendon rupture in younger patients.

Purpose/hypothesis: To review the clinical outcomes of patients who underwent quadriceps tendon repair at age ≤40 years. We hypothesized that this cohort would experience better clinical outcomes in comparison to historical older controls.

Study design: Case series; Level of evidence, 4.

Methods: Using an institutional database, we retrospectively identified patients who underwent quadriceps tendon repair between January 2009 and December 2017. Patients were included in the study if they were aged ≤40 years at the time of surgery and had sustained an isolated, complete tendon rupture. Patient and injury characteristics were recorded. Patients were contacted to complete a custom survey, the 2000 International Knee Documentation Committee (IKDC) form, the Lysholm scale, and the Tegner scale.

Results: Included were 38 patients (86.8% male; mean age, 32.0 ± 6.9 years; age range, 15-40 years), with a mean follow-up of 5.9 ± 2.3 years (range, 2.4-11.3 years). At final follow-up, the mean IKDC score was 74.1 ± 22.6 (range, 26.4-100.0), and the mean Lysholm score was 85.4 ± 20.0 (range, 30-100), which were similar if not inferior to historical controls of patients >40 years. Only 16 patients (42.1%) had unchanged or higher Tegner scores after surgery, whereas 22 patients (57.9%) reported lower postoperative activity level. Overall, 91.2% (31/34) of workers returned at a mean 3.9 months after surgery, whereas 63% (12/19) of athletes were able to return to play at 8.8 months. At final follow-up, 12 patients (31.6%) reported persistent pain and stiffness in their knees. Additionally, 3 patients (7.9%) reported pain without stiffness, and 4 (10.5%) reported stiffness without pain. Patients reporting pain or stiffness had significantly lower IKDC scores, Lysholm scores, postoperative Tegner scores, and change in their Tegner score at final follow-up in comparison to those who did not report pain or stiffness.

Conclusion: Although patients aged ≤40 years had satisfactory outcomes after quadriceps tendon repair, this injury resulted in significant long-term sequelae in a substantial percentage of patients, despite their youth. Further, this group did not have better outcomes compared with historical controls aged > 40 years.

Keywords: quadriceps tendon repair; quadriceps tendon rupture; return to play; return to work.

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Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: T.D. has received education payments from Liberty Surgical. P.O. has received education payments from Liberty Surgical, Smith & Nephew, and Summit Surgical. S.B.C. has received research support from Arthrex and Major League Baseball, consulting fees from ConMed Linvatec and Zimmer, speaking fees from Zimmer, and royalties from Slack and Zimmer. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

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