Nicholas B VanDerwerker, Alec E Winzenried, Samuel J Mosiman, Brian F Grogan, Geoffrey S Baer, Eric J Cotter
{"title":"与缝合锚钉相比，经骨隧道缝合固定在原发性股四头肌肌腱修复中的再破裂率和患者报告的结果指标相似：一项系统综述。","authors":"Nicholas B VanDerwerker, Alec E Winzenried, Samuel J Mosiman, Brian F Grogan, Geoffrey S Baer, Eric J Cotter","doi":"10.1016/j.arthro.2025.04.059","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To compare the clinical outcomes of transosseous tunnel (TO) techniques to suture anchor (SA) techniques for the primary repair of unilateral quadriceps tendon ruptures (QTRs).</p><p><strong>Methods: </strong>A systematic review of the PubMed database was performed for studies containing rerupture and/or patient-reported outcome measure (PROM) outcome data of primary QTR repairs utilizing TO and/or SA techniques. Included studies were evaluated using the Methodological Index for Nonrandomized Studies scoring system.</p><p><strong>Results: </strong>Twelve studies including 600 patients met inclusion criteria for the systematic review. The level of evidence for these studies ranged from III to IV, with most (n = 10; 83.3%) being retrospective case series. Within included studies, TO repairs accounted for 79.5% of patients (n = 477), while 20.5% (n = 123) underwent repair using SA. All publications using SAs reported placing 2 to 3 anchors for the primary QTR repair. Studies reporting using TO methods mostly placed 3 patellar drill holes, although 1 study only used 2 drill holes, 2 studies used 3 to 4 drill holes, and 3 studies did not report this information. QTR rerupture rates varied between 0% and 16.7% for TO techniques and between 0% and 14.7% for SA techniques. PROM collection varied widely, with limited data to clearly show the superiority of TO or SA techniques. The methodologic quality for noncomparative studies was moderate, with a mean score of 10.2 ± 1.3 (range, 8-12), and was moderate for comparative studies, with a mean score of 15.7 ± 2.1 (range, 14-18).</p><p><strong>Conclusions: </strong>Rerupture rates were similar between TO and SA repair methods for primary QTR repairs. Some data indicate that SA techniques might show superior outcomes based on PROMs between SA and TO methods for the primary repair of QTRs, but high-quality evidence is lacking.</p><p><strong>Level of evidence: </strong>Level IV, systematic review of Level III and IV studies.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":" ","pages":""},"PeriodicalIF":5.4000,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Transosseous Tunnel Suture Fixation Results in Similar Rerupture Rates and Patient-Reported Outcome Measures Compared to Suture Anchors for Primary Quadriceps Tendon Repair: A Systematic Review.\",\"authors\":\"Nicholas B VanDerwerker, Alec E Winzenried, Samuel J Mosiman, Brian F Grogan, Geoffrey S Baer, Eric J Cotter\",\"doi\":\"10.1016/j.arthro.2025.04.059\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To compare the clinical outcomes of transosseous tunnel (TO) techniques to suture anchor (SA) techniques for the primary repair of unilateral quadriceps tendon ruptures (QTRs).</p><p><strong>Methods: </strong>A systematic review of the PubMed database was performed for studies containing rerupture and/or patient-reported outcome measure (PROM) outcome data of primary QTR repairs utilizing TO and/or SA techniques. Included studies were evaluated using the Methodological Index for Nonrandomized Studies scoring system.</p><p><strong>Results: </strong>Twelve studies including 600 patients met inclusion criteria for the systematic review. The level of evidence for these studies ranged from III to IV, with most (n = 10; 83.3%) being retrospective case series. Within included studies, TO repairs accounted for 79.5% of patients (n = 477), while 20.5% (n = 123) underwent repair using SA. All publications using SAs reported placing 2 to 3 anchors for the primary QTR repair. Studies reporting using TO methods mostly placed 3 patellar drill holes, although 1 study only used 2 drill holes, 2 studies used 3 to 4 drill holes, and 3 studies did not report this information. QTR rerupture rates varied between 0% and 16.7% for TO techniques and between 0% and 14.7% for SA techniques. PROM collection varied widely, with limited data to clearly show the superiority of TO or SA techniques. The methodologic quality for noncomparative studies was moderate, with a mean score of 10.2 ± 1.3 (range, 8-12), and was moderate for comparative studies, with a mean score of 15.7 ± 2.1 (range, 14-18).</p><p><strong>Conclusions: </strong>Rerupture rates were similar between TO and SA repair methods for primary QTR repairs. Some data indicate that SA techniques might show superior outcomes based on PROMs between SA and TO methods for the primary repair of QTRs, but high-quality evidence is lacking.</p><p><strong>Level of evidence: </strong>Level IV, systematic review of Level III and IV studies.</p>\",\"PeriodicalId\":55459,\"journal\":{\"name\":\"Arthroscopy-The Journal of Arthroscopic and Related Surgery\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":5.4000,\"publicationDate\":\"2025-05-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Arthroscopy-The Journal of Arthroscopic and Related Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.arthro.2025.04.059\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.arthro.2025.04.059","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
Transosseous Tunnel Suture Fixation Results in Similar Rerupture Rates and Patient-Reported Outcome Measures Compared to Suture Anchors for Primary Quadriceps Tendon Repair: A Systematic Review.
Purpose: To compare the clinical outcomes of transosseous tunnel (TO) techniques to suture anchor (SA) techniques for the primary repair of unilateral quadriceps tendon ruptures (QTRs).
Methods: A systematic review of the PubMed database was performed for studies containing rerupture and/or patient-reported outcome measure (PROM) outcome data of primary QTR repairs utilizing TO and/or SA techniques. Included studies were evaluated using the Methodological Index for Nonrandomized Studies scoring system.
Results: Twelve studies including 600 patients met inclusion criteria for the systematic review. The level of evidence for these studies ranged from III to IV, with most (n = 10; 83.3%) being retrospective case series. Within included studies, TO repairs accounted for 79.5% of patients (n = 477), while 20.5% (n = 123) underwent repair using SA. All publications using SAs reported placing 2 to 3 anchors for the primary QTR repair. Studies reporting using TO methods mostly placed 3 patellar drill holes, although 1 study only used 2 drill holes, 2 studies used 3 to 4 drill holes, and 3 studies did not report this information. QTR rerupture rates varied between 0% and 16.7% for TO techniques and between 0% and 14.7% for SA techniques. PROM collection varied widely, with limited data to clearly show the superiority of TO or SA techniques. The methodologic quality for noncomparative studies was moderate, with a mean score of 10.2 ± 1.3 (range, 8-12), and was moderate for comparative studies, with a mean score of 15.7 ± 2.1 (range, 14-18).
Conclusions: Rerupture rates were similar between TO and SA repair methods for primary QTR repairs. Some data indicate that SA techniques might show superior outcomes based on PROMs between SA and TO methods for the primary repair of QTRs, but high-quality evidence is lacking.
Level of evidence: Level IV, systematic review of Level III and IV studies.
期刊介绍：
Nowhere is minimally invasive surgery explained better than in Arthroscopy, the leading peer-reviewed journal in the field. Every issue enables you to put into perspective the usefulness of the various emerging arthroscopic techniques. The advantages and disadvantages of these methods -- along with their applications in various situations -- are discussed in relation to their efficiency, efficacy and cost benefit. As a special incentive, paid subscribers also receive access to the journal expanded website.
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