Purpose
To evaluate 1-year outcomes in active-duty servicemembers who underwent patellar tendon
rupture repair and to identify baseline variables associated with return to activity.
Methods
We performed a retrospective review of all active-duty servicemembers undergoing primary
patellar tendon rupture repair between 2009 and 2014. All patients had a minimum 12-month
follow-up. Demographic variables were recorded, as well as ability to return to impact
activities and remain on active-duty status. Rates of recurrent rupture and revision
surgery were identified. Univariate analysis was performed to assess relations between
outcomes and baseline variables.
Results
A total of 123 patients met the inclusion criteria (average age, 33.5 ± 6.6 years;
99% male patients) with a mean follow-up period of 4.3 ± 2.2 years. Whereas 67.4%
of patients returned to running at an average of 8.3 months from index surgery, only
42.4% of patients resumed unrestricted occupational function. Higher rates of return
to running were observed among patients with senior military rank (P = .046). Senior military rank was also associated with a higher rate of return to
unrestricted active-duty status (P = .006). Logistic regression analysis showed an association between postoperative
pain (odds ratio [OR], 0.684; 95% confidence interval [CI], 0.56-0.84; P < .001) and return to running, between postoperative pain (OR, 0.77; 95% CI, 0.60-0.98;
P = .033) and return to active duty, and between rank (OR, 2.06; 95% CI, 1.04-4.07;
P = .037) and return to active duty. Patients who sustained injuries during deployment
had a higher rate of recurrent rupture (26.1% vs 9.3%, P = .028).
Conclusions
At 1-year follow-up, approximately two-thirds of military servicemembers undergoing
primary patellar tendon repair had returned to running after surgery, whereas fewer
than one-half returned to full military duty. Younger age and more senior military
rank were associated with higher rates of return to running. Additionally, servicemembers
of higher rank, particularly officers, had statistically higher rates of return to
unrestricted activity.
Level of Evidence
Level IV, therapeutic case series.
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References
- Incidence of major tendon ruptures and anterior cruciate ligament tears in US Army soldiers.Am J Sports Med. 2007; 35: 1308-1314
- Operative treatment of acute patellar tendon ruptures.Am J Sports Med. 2020; 48: 2686-2691
- Patellar and quadriceps tendon ruptures—Jumper's knee.Am J Sports Med. 1984; 12: 375-380
- Isolated rupture of the patellar tendon in athletes.Am J Sports Med. 1994; 22: 692-695
- Primary repair of patellar tendon rupture without augmentation.Am J Sports Med. 1999; 27: 304-307
- Primary patellar tendon repair and early mobilization: Results in an active-duty population.J South Orthop Assoc. 2001; 10: 17-23
- Incidence and risk factors of acute patellar tendon rupture, repair failure, and return to activity in the active-duty military population.Am J Sports Med. 2021; 49: 2916-2923
- Functional outcomes after isolated and combined posterior cruciate ligament reconstruction in a military population.Orthop J Sports Med. 2019; 72325967119875139
- Autologous chondrocyte implantation and tibial tubercle osteotomy for patellofemoral chondral defects: Improved pain relief and occupational outcomes among US Army servicemembers.Am J Sports Med. 2018; 46: 3198-3208
- Disabilities due to injury in the military.Am J Prev Med. 2000; 18: 33-40
- Clinical utilization of deployed military surgeons.J Trauma Acute Care Surg. 2021; 91: S256-S260
- Letter regarding “Clinical utilization of deployed military surgeons”.J Trauma Acute Care Surg. 2022; 92: e139-e140
- Occupational risk factors for osteoarthritis of the knee: A meta-analysis.Osteoarthritis Cartilage. 2011; 19: 829-839
- The rising incidence of degenerative and posttraumatic osteoarthritis of the knee in the United States military.J Arthroplasty. 2016; 31: 2108-2114
- Incidence of physician-diagnosed osteoarthritis among active duty United States military service members.Arthritis Rheum. 2011; 63: 2974-2982
Article info
Publication history
Published online: October 31, 2022
Accepted:
September 2,
2022
Received:
March 6,
2022
Footnotes
The authors report the following potential conflicts of interest or sources of funding: B.R.W. is a board or committee member of American Academy of Orthopaedic Surgeons, AANA, and Society of Military Orthopaedic Surgeons; is on the editorial or governing board of American Journal of Orthopedics and Arthroscopy; receives publishing royalties and financial or material support from Elsevier; and is a paid presenter or speaker for Genzyme, outside the submitted work. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
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