Purpose
We aimed to investigate the clinical and functional outcomes, including maximal and
explosive strength, after chronic quadriceps tendon rupture repair with Modified Pulvertaft
on Weave (MPW) technique
Methods
Knee joint range of motion (ROM), patella height, thigh circumference, and Lysholm
and International Knee Documentation Committee (IKDC) scores were assessed preoperatively
and postoperatively. The knee extensors maximal (isokinetic peak torque and isometric
maximal voluntary contraction (MVC) torque) and explosive strength—rate of torque
development (RTD) early [RTD50 and RTD100] and late [RTD250]—were performed. We assessed the thigh circumference and vastus lateralis muscle
thickness (MT) as indicators of quadriceps muscle mass, and the voluntary quadriceps
activation using surface electromyography (EMG50).
Results
Nine patients (mean age: 53 ± 11 years) took part in the study. We observed a significant
increase in the knee active ROM and a decreased extension deficit (both, P < .001), but not for pain (P = .07), IKDC (P = .07), and Lysholm (P = .21) after the surgery. We did not observe a difference between involved (n = 8) and uninvolved (n = 10) limbs for ROM, thigh circumference, and MT. We observed differences for extensors
peak torque, MVC torque, and late RTD (all, P < .05). However, we did not observe differences for early RTD and EMG50. Significant positive correlations were observed for RTD50 (ρ = .80) and RTD100 (ρ = .81) vs EMG50. Both the IKDC and Lysholm were better correlated with the early than with later
RTD.
Conclusions
The MPW reestablished the active knee extension. The same level of quadriceps muscle
mass was observed in both limbs, suggesting a lack of hypotrophy due to the injury.
Although the involved limb had demonstrated lower knee extensors maximal strength,
they demonstrate an equivalent early RTD when compared to the uninvolved limb. The
early RTD seems to be better correlated with the patient’s functionality than the
later RTD and maximal strength.
Level of Evidence
IV, case series.
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Article info
Publication history
Published online: January 31, 2022
Accepted:
January 16,
2022
Received:
May 25,
2021
Footnotes
The authors report no conflicts of interest in the authorship and publication of this article. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
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© 2022 by the Arthroscopy Association of North America
