Gait analysis and body composition after treatment of quadriceps tendon ruptures showed equal results independent of suture anchor or transosseus repair technique used: a pilot study

Abstract

Purpose: Suture anchor repair is a fairly new surgical technique for quadriceps tendon ruptures. It is supposed to be superior to the standard transosseus sutures because of biomechanical superiority and – due to a less invasive surgery – earlier rehabilitation onset. This study focused on analyzing functionality of the quadriceps muscle during gait as well as body composition between a suture anchor and a transosseus suture repair group and is the first study that undertook systematic gait analyses in this patient population.

Materials and methods: Seventeen patients who underwent either suture anchor (9 subjects) or transosseus suture repair surgery (8 subjects) at two different trauma surgery centers between 2010 and 2015 were included. Gait analysis was performed with a three dimensional motion capture system (Vicon) and body composition was assessed with bioelectrical impedance analysis (Nutribox). Parametrical statistical analyses were conducted using independent t-tests.

Results: No statistically significant differences were found in any outcome parameter of gait analysis or body composition measurement.

Conclusion: Suture anchor repair shows equal results to transosseus suture repair technique regarding gait quality and body composition.

Implications for rehabilitation

• In a long term follow-up suture anchor repair shows similar results to the transosseus suture technique regarding body composition and musculus quadriceps function in gait.

• Without the implementation of an appropriate rehabilitation protocol incorporating the earlier load-carrying capacity, early biomechanical advantages of suture anchor technique over transosseus sutures might vanish over time.

• The decision which surgery technique might be best for the individual patient, should not be based on the expectation that suture anchor repair alone without considering appropriate rehabilitation would lead to long term functional advantages over transosseus suture technique.

Keywords:

• Knee
• quadriceps tendon repair
• surgery
• Vicon
• BiA

Ethical approval

This article was written complying the international guidelines of good scientific practice. As there is a limited number of patients who underwent either suture anchor or transosseus suture repair surgery in Austria, there might be a chance to identify patients from anonymized datasets. Therefore, full data sets will be made available by Timothy Hasenoehrl and Harald Widhalm if contacted by researchers who meet the criteria for access to confidential data.

Acknowledgements

This paper was written by an interdisciplinary team at the Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Austria, the Department of Orthopedics and Trauma Surgery, Division of Trauma-Surgery, Medical University of Vienna, Austria, the Department of Orthopedics and Traumatology, LK Baden-Mödling-Hainburg, Baden, Austria and the Department of Trauma Surgery and Sports Traumatology, Danube Hospital, Vienna, Austria. The preparation of this study and the respective article took place within the scope of the regular research work. No further financial relationships exist. No funding was received for the creation of this article. The authors would like to thank Claudia Gahleitner, Medical University of Vienna, Austria for assistance with statistical analysis.

Disclosure statement

No potential conflict of interest was reported by the authors.