Return to sport after acute patellar tendon repair: identifying key prognostic factors.

PURPOSE: To answer three clinically oriented questions after acute patellar tendon repair: how often and how quickly patients return to sport (RTS), which patient factors are associated with RTS, and whether repair technique is associated with RTS under a common surgical and rehabilitation protocol.

METHODS

Single-centre retrospective cohort of 46 consecutive adults treated for acute complete patellar tendon rupture at a public university hospital (2014-2022). Repairs were performed by a single surgeon using either suture anchors (n = 25) or transosseous tunnels (n = 21); technique availability was determined by hospital tendering/procurement processes. Outcomes were time to RTS and RTS by last follow-up. Analyses were descriptive, with simplified adjusted models for age, sex, body mass index (BMI), comorbidity, pre-injury sport impact, and repair technique.

RESULTS

Overall, 87.0% (40/46) returned to sport at a mean of 5.88 +/- 0.35 months. Higher BMI was associated with slower RTS (HR 0.82 per +5 kg/m2; 95% CI 0.68-0.99; p = 0.041) and lower odds of RTS (OR 0.62 per +5 kg/m2; 95% CI 0.39-0.98; p = 0.042). Age showed a non-significant trend toward slower RTS. Descriptive comparisons showed no significant between-technique differences in postoperative outcomes.

CONCLUSIONS

Most patients resumed sport during the first postoperative semester. BMI, and less consistently age, appeared more relevant to RTS prognosis than the choice between anchor- and tunnel-based repair, although the small sample size requires cautious interpretation.

LEVEL OF EVIDENCE: III; retrospective cohort study.