Low Tensile Strength Suture With Transosseous Tunnels and Suture Anchors 5 mm in Diameter or Greater Are Associated With Higher Failure Rates in Primary Patellar Tendon Repair

Purpose: To determine the rate of and risk factors for clinical failure and return to military duty following primary patellar tendon repair with either transosseous trunnel repair or suture anchor repair. Methods: The Military Health System Data Repository (MDR) was queried to identify all adult pa...

Full description

Bibliographic Details
Main Authors: Mark S. Katsma, D.O., Vaughn Land, M.D., S. Hunter Renfro, M.D., Hunter Culp, M.D., George C. Balazs, M.D.
Format: Article
Language:English
Published: Elsevier 2024-04-01
Series:Arthroscopy, Sports Medicine, and Rehabilitation
Online Access:http://www.sciencedirect.com/science/article/pii/S2666061X24000269
_version_ 1797272398563639296
author Mark S. Katsma, D.O.
Vaughn Land, M.D.
S. Hunter Renfro, M.D.
Hunter Culp, M.D.
George C. Balazs, M.D.
author_facet Mark S. Katsma, D.O.
Vaughn Land, M.D.
S. Hunter Renfro, M.D.
Hunter Culp, M.D.
George C. Balazs, M.D.
author_sort Mark S. Katsma, D.O.
collection DOAJ
description Purpose: To determine the rate of and risk factors for clinical failure and return to military duty following primary patellar tendon repair with either transosseous trunnel repair or suture anchor repair. Methods: The Military Health System Data Repository (MDR) was queried to identify all adult patients undergoing surgical treatment of a patellar tendon rupture in the Military Health System from 2014 to 2018. Patients who underwent either transosseous tunnel repair or suture anchor repair were included. Health records were examined to collect additional data. Univariate analysis and multivariate logistic regression models were used to determine independent risk factors for rerupture. Results: A total of 450 knees in 437 patients were included. Transosseous tunnel repair was the most frequently used technique (314/450, 77%), followed by suture anchor repair (113/450, 25%). Rerupture occurred in 33 knees (7%). There was no difference in rerupture rate between transosseous tunnel repair and suture anchor repair (P = .15), and this result persisted within the multivariate logistic regression model. Among transosseous tunnel repairs, use of low tensile strength suture was an independent risk factor for repair failure (odds ratio [OR], 3.4; P = .016). Among suture anchor repairs, use of anchors 5.0 mm in diameter or greater (OR, 12.0; P = .027) was an independent risk factor for repair failure. Conclusions: There is no statistically significant difference in failure rate between transosseous tunnel repair and suture anchor repair in primary patellar tendon ruptures. However, the use of low tensile strength suture with transosseous tunnels and the use of suture anchors 5.0 mm in diameter or greater resulted in significantly higher failure rates. These data suggest that use of high tensile strength suture in transosseous tunnel repair and use of suture anchors less than 5.0 mm in diameter in suture anchor repair result in lower failure rate in primary patellar tendon repair. Level of Evidence: Level III, retrospective cohort study.
first_indexed 2024-03-07T14:27:46Z
format Article
id doaj.art-15c8f09b9fb34dfe9a82ef73f388e4c0
institution Directory Open Access Journal
issn 2666-061X
language English
last_indexed 2024-03-07T14:27:46Z
publishDate 2024-04-01
publisher Elsevier
record_format Article
series Arthroscopy, Sports Medicine, and Rehabilitation
spelling doaj.art-15c8f09b9fb34dfe9a82ef73f388e4c02024-03-06T05:28:42ZengElsevierArthroscopy, Sports Medicine, and Rehabilitation2666-061X2024-04-0162100908Low Tensile Strength Suture With Transosseous Tunnels and Suture Anchors 5 mm in Diameter or Greater Are Associated With Higher Failure Rates in Primary Patellar Tendon RepairMark S. Katsma, D.O.0Vaughn Land, M.D.1S. Hunter Renfro, M.D.2Hunter Culp, M.D.3George C. Balazs, M.D.4Bone & Joint Sports Medicine Institute, Naval Medical Center Portsmouth, Portsmouth, Virginia, U.S.A.Bone & Joint Sports Medicine Institute, Naval Medical Center Portsmouth, Portsmouth, Virginia, U.S.A.Bone & Joint Sports Medicine Institute, Naval Medical Center Portsmouth, Portsmouth, Virginia, U.S.A.Bone & Joint Sports Medicine Institute, Naval Medical Center Portsmouth, Portsmouth, Virginia, U.S.A.Bone & Joint Sports Medicine Institute, Naval Medical Center Portsmouth, Portsmouth, Virginia, U.S.A.; Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland, U.S.A.; Address correspondence to George C. Balazs, M.D., 620 John Paul Jones Cir, Portsmouth, VA 23707, U.S.A.Purpose: To determine the rate of and risk factors for clinical failure and return to military duty following primary patellar tendon repair with either transosseous trunnel repair or suture anchor repair. Methods: The Military Health System Data Repository (MDR) was queried to identify all adult patients undergoing surgical treatment of a patellar tendon rupture in the Military Health System from 2014 to 2018. Patients who underwent either transosseous tunnel repair or suture anchor repair were included. Health records were examined to collect additional data. Univariate analysis and multivariate logistic regression models were used to determine independent risk factors for rerupture. Results: A total of 450 knees in 437 patients were included. Transosseous tunnel repair was the most frequently used technique (314/450, 77%), followed by suture anchor repair (113/450, 25%). Rerupture occurred in 33 knees (7%). There was no difference in rerupture rate between transosseous tunnel repair and suture anchor repair (P = .15), and this result persisted within the multivariate logistic regression model. Among transosseous tunnel repairs, use of low tensile strength suture was an independent risk factor for repair failure (odds ratio [OR], 3.4; P = .016). Among suture anchor repairs, use of anchors 5.0 mm in diameter or greater (OR, 12.0; P = .027) was an independent risk factor for repair failure. Conclusions: There is no statistically significant difference in failure rate between transosseous tunnel repair and suture anchor repair in primary patellar tendon ruptures. However, the use of low tensile strength suture with transosseous tunnels and the use of suture anchors 5.0 mm in diameter or greater resulted in significantly higher failure rates. These data suggest that use of high tensile strength suture in transosseous tunnel repair and use of suture anchors less than 5.0 mm in diameter in suture anchor repair result in lower failure rate in primary patellar tendon repair. Level of Evidence: Level III, retrospective cohort study.http://www.sciencedirect.com/science/article/pii/S2666061X24000269
spellingShingle Mark S. Katsma, D.O.
Vaughn Land, M.D.
S. Hunter Renfro, M.D.
Hunter Culp, M.D.
George C. Balazs, M.D.
Low Tensile Strength Suture With Transosseous Tunnels and Suture Anchors 5 mm in Diameter or Greater Are Associated With Higher Failure Rates in Primary Patellar Tendon Repair
Arthroscopy, Sports Medicine, and Rehabilitation
title Low Tensile Strength Suture With Transosseous Tunnels and Suture Anchors 5 mm in Diameter or Greater Are Associated With Higher Failure Rates in Primary Patellar Tendon Repair
title_full Low Tensile Strength Suture With Transosseous Tunnels and Suture Anchors 5 mm in Diameter or Greater Are Associated With Higher Failure Rates in Primary Patellar Tendon Repair
title_fullStr Low Tensile Strength Suture With Transosseous Tunnels and Suture Anchors 5 mm in Diameter or Greater Are Associated With Higher Failure Rates in Primary Patellar Tendon Repair
title_full_unstemmed Low Tensile Strength Suture With Transosseous Tunnels and Suture Anchors 5 mm in Diameter or Greater Are Associated With Higher Failure Rates in Primary Patellar Tendon Repair
title_short Low Tensile Strength Suture With Transosseous Tunnels and Suture Anchors 5 mm in Diameter or Greater Are Associated With Higher Failure Rates in Primary Patellar Tendon Repair
title_sort low tensile strength suture with transosseous tunnels and suture anchors 5 mm in diameter or greater are associated with higher failure rates in primary patellar tendon repair
url http://www.sciencedirect.com/science/article/pii/S2666061X24000269
work_keys_str_mv AT markskatsmado lowtensilestrengthsuturewithtransosseoustunnelsandsutureanchors5mmindiameterorgreaterareassociatedwithhigherfailureratesinprimarypatellartendonrepair
AT vaughnlandmd lowtensilestrengthsuturewithtransosseoustunnelsandsutureanchors5mmindiameterorgreaterareassociatedwithhigherfailureratesinprimarypatellartendonrepair
AT shunterrenfromd lowtensilestrengthsuturewithtransosseoustunnelsandsutureanchors5mmindiameterorgreaterareassociatedwithhigherfailureratesinprimarypatellartendonrepair
AT hunterculpmd lowtensilestrengthsuturewithtransosseoustunnelsandsutureanchors5mmindiameterorgreaterareassociatedwithhigherfailureratesinprimarypatellartendonrepair
AT georgecbalazsmd lowtensilestrengthsuturewithtransosseoustunnelsandsutureanchors5mmindiameterorgreaterareassociatedwithhigherfailureratesinprimarypatellartendonrepair