[Effectiveness of a suture bridge technique for repair of quadriceps tendon rupture in uraemic patients].

OBJECTIVE: To investigate the effectiveness of a suture bridge technique for quadriceps tendon rupture repair in uraemic patients.

METHODS: Between March 2010 and September 2012, 10 uraemic patients (14 sides) with quadriceps tendon rupture were treated with the suture bridge technique. Of them, 8 were male and 2 were female, aged from 30 to 62 years (mean, 54.2 years). The duration of uremia was 3-11 years (mean, 5.5 years): the duration of quadriceps tendon rupture was 5 days to 2 months (median, 12 days). Six cases had a trauma history, and one case had diabetes. The left side was involved in 2 cases, the right side in 4 cases, and both sides in 4 cases. The active range of motion (ROM) of the knees was (115.0 +/- 8.3) degrees in flexion, and (72.5 +/- 21.2) degrees in extension. Lysholm score was 19.5 +/- 16.3. X-ray films showed downward shifting of patella. MRI revealed discontinuity between distal quadriceps tendon and upper pole of patella.

RESULTS: The operation time was 30-50 minutes (mean, 40.3 minutes). Primary healing of incision was obtained in all patients without complications. All patients were followed up 12-25 months (mean, 16.3 months). There was no re-rupture of quadriceps tendon or loosening of internal fixation during follow-up. At last follow-up, the active ROM of the knees was (121.0 +/- 7.9) degrees in flexion, showing no significant difference when compared with preoperative one (t = -2.075, P =0.058); the active ROM was (8.2 +/- 6.1) degrees in extension, showing significant difference when compared with preoperative one (t = 11.702, P = 0.000). Lysholm score was 84.6 +/- 12.4, showing significant difference when compared with preoperative score (t = -16.226, P = 0.000). According to the American Knee Society score (KSS), the results were excellent in 4 sides, good in 9 sides, and fair in 1 side, and the total excellent and good rate was 92.9%. At last follow-up, the active ROM of the knee, Lysholm score, and KSS score were significantly better in young patients (< 45 years) than in elder patients (> or = 45 years), and in patients receiving early operation (< 2 weeks) than in patients receiving late operation (> or = 2 weeks) (P < 0.05).

CONCLUSION: For fewer traumas and early functional exercise after operation, the suture bridge technique benefits functional restoration of knee joint in uraemic patients. Operation chance and age seem to be important factors to the results. Early operation should be considered when quadriceps tendon ruptured.