[Artículo traducido] Anclajes de sutura frente a túneles transóseos para la rotura aguda del tendón rotuliano: estudio de cohorte comparativo retrospectivo

Abstract

Background

Whether suture anchors (SA) offer meaningful advantages over transosseous tunnels (TT) for primary repair of acute patellar tendon rupture remains uncertain.

Methods

Single-center retrospective cohort (January 2014-December 2022) of adults with acute patellar tendon rupture treated with SA or TT in two consecutive cohorts, non-overlapping temporal cohorts. Primary outcome was overall recorded operative time (no phase-specific timings); secondary outcomes were pain (VAS), range of motion (ROM), return to sport/work, Lysholm, EQ-5D VAS, EQ-5D index, and complications/reoperation. Multivariable models adjusted for age, sex, BMI, corticosteroid therapy, smoking, diabetes, chronic kidney disease, and technique (two-sided p < 0.05). No peri-tendinous augmentation was performed.

Results

Of 55 screened cases, 46 met criteria (SA n = 25; TT n = 21). Mean follow-up was 5.1 ± 3.7 years (SA 5.16 ± 3.48 vs. TT 5.00 ± 3.22; p = 0.760). Unadjusted operative time was lower with SA (78.7 ± 21.2 vs. 99.6 ± 30.1 min; p = 0.085). In multivariable linear regression, SA was associated with an adjusted −20.0-min difference (95% CI: −35.2 to −4.8; p = 0.012). This association reached statistical significance after covariate adjustment. No adjusted between-group differences were detected for pain, ROM, return to sport/work, Lysholm, EQ-5D VAS, or EQ-5D index. Complications were similar (adjusted OR: 1.15; 95% CI: 0.68-1.95; p = 0.45).

Conclusions

Suture anchors were associated with shorter overall recorded operative time than transosseous tunnels, with no detectable differences in clinical outcomes or complications. Both constructs appear reliable with standardized rehabilitation; findings are hypothesis-generating given nonrandomized temporal allocation and unmeasured intra-operative determinants.

Level of evidence

IV (retrospective cohort).