Primary repair of patellar tendon rupture without augmentation
Primary repair of patellar tendon rupture without augmentation
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DOI：
10.1177/03635465990270030601
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发表时间：
1999-05-01
影响因子：
4.8
通讯作者：
Timmerman, LA
中科院分区：
文献类型：
--
作者：
Marder, RA;Timmerman, LA
髌腱断裂的修复通常依赖于环扎加固和延长伸展时的制动。我们报告了我们在撕脱伤和中间层破裂方面的经验，这两种情况均采用一期修复术治疗，无需加固，允许40岁以下的运动员早期活动。进行修复，使膝关节屈曲超过60度。使用足跟滑动进行康复，前3周允许屈曲至45度，3至6周增加至90度，此后不受限制。采用了加速负重和肌肉强化计划。平均随访2.6年（范围：20至61个月），12例患者恢复到以前的活动水平。未观察到伸展或伸肌滞后损失;平均屈曲损失为5度。髌股症状和体征存在于5例患者中，但活动受限的只有2例。60度/秒时的平均峰值扭矩为92%（范围：73%-105%）。平均Lysholm评分为94 ± 2.5分。一期修复即刻保护活动度，结果一致良好，无需操作或随后取出硬件。
Repair of patellar tendon ruptures has often relied on cerclage augmentation and prolonged immobilization in extension. We are reporting our experience with avulsion injuries as well as midsubstance ruptures, both treated with primary repair without augmentation, allowing early mobilization in the athlete less than 40 years of age. Repairs were performed to allow knee flexion to more than 60 degrees. Rehabilitation was performed with heel slides, allowing flexion to 45 degrees for the first 3 weeks, increasing to 90 degrees at 3 to 6 weeks, and thereafter without restriction. An accelerated weightbearing and muscle strengthening program was adopted. At a mean follow-up of 2.6 years (range, 20 to 61 months), 12 patients had returned to their previous levels of activity. No loss of extension or extensor lag was noted; mean flexion loss was 5 degrees. Patellofemoral symptoms and signs were present in five patients, but activity was limited in only two. Mean peak torque at 60 deg/sec was 92% (range, 73% to 105%). Mean Lysholm score was 94 +/- 2.5 points. Primary repair with immediate, protected range of motion resulted in uniformly excellent results and obviated the need for manipulation or subsequent hardware removal.