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Less-invasive technique shows promise for repair of quadriceps tendon ruptures

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A minimally invasive surgical technique may be better for repairing quadriceps tendon ruptures, a new study suggests.

Quadriceps tendon ruptures are knee injuries that typically occur in adults aged over 40 and can be caused by obesity, illness or traumatic injuries.

Researchers at the University of Missouri used human cadaveric tendon specimens to compare the biomechanical fixation strength of the current “gold-standard” technique for repairing these ruptures, transosseous (through-the-bone) tunnel repair, versus the less-invasive suture anchor technique.

They found that suture anchors responded better to strength-testing after the surgery, supporting more movement in the knee earlier in the recovery process.

“The suture anchor technique requires a smaller incision and disrupts less of the patient´s normal anatomy around the knee,” explained Dr. Seth L. Sherman, assistant professor of orthopaedic surgery at the University of Missouri School of Medicine. “By using a minimally invasive approach, we create a better healing environment for the knee, which supports more movement in the knee earlier after surgery.”

The study also found that the suture anchors had the same ultimate strength as transosseous tunnel repairs.

However, the authors noted that although the suture anchor technique has advantages, such as shorter operating time and less damage to soft tissue, one disadvantage is the cost effectiveness of the procedure. Sherman cited a 2012 study which found the cost of using suture anchors ranged from $435 (£300) to $560 (£387) per patient — approximately $190 (£131) to $320 (£221) more than the transosseous technique.

Earlier rehabilitation in the suture anchor group may offset this initial difference.

Sherman has started using the suture anchor technique in living human patients and plans to compare the healing time of the two techniques in future research, the University of Missouri reported.

“Although a clinical study is needed to confirm this technique as a viable alternative to the current gold-standard technique, these results support suture anchors as a viable, less-invasive alternative to repairs of the quadriceps tendon,” Sherman concluded.

The study has been published in Arthroscopy: The Journal of Arthroscopic and Related Surgery.

http://medicine.missouri.edu/news/20160516-minimally-invasive-tendon-repair.php

http://www.arthroscopyjournal.org/article/S0749-8063 %2815%2900973-1/pdf