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Bicortical Titanium Tenodesis Button With Double-Row Fixation for the Treatment of Proximal Rectus Femoris Avulsion: Review of Literature and Surgical Technique.

ABSTRACT: In adult populations, rectus femoris avulsions are reported in professional soccer and football players but are noted to be exceptionally rare. No gold standard or recommendations exist for this injury; however, in cases of avulsion at the anterior inferior iliac spine, positive outcomes appear to result from rest, immobilization, and rehabilitation. Surgery is typically reserved for cases with large retractions of bone fragments or unsuccessful nonoperative treatment. Surgical treatment methods vary from direct suture repair to single- and double-row bone suture placement and even muscle-muscle repair. We present our technique using a bicortical tenodesis button with double-row fixation for the treatment of a severely retracted rectus femoris tendon avulsion in a high-level athlete.

SUBMITTER: Hoang V

PROVIDER: S-EPMC8252836 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundRectus femoris injuries are common among athletes, especially in kicking sports such as soccer; however, proximal rectus femoris avulsions in athletes are a relatively rare entity.Purpose/hypothesisThe purpose of this study was to describe and report the results of an original technique of surgical excision of the proximal tendon remnant followed by a muscular suture repair. Our hypothesis was that this technique limits the risk of recurrence in high-level athletes and allows for rapid recovery without loss of quadriceps strength.Study designCase series; Level of evidence, 4.MethodsOur retrospective series included 5 players aged 31.8 ± 3.9 years with acute proximal rectus femoris avulsion injuries who underwent a surgical resection of the proximal tendon between March 2012 and June 2014. Four of these players had recurrent rectus femoris injuries in the 9 months before surgery, while 1 player had surgery after a first injury. Mean follow-up was 18.2 ± 12.6 months, and minimum follow-up was 9 months. We analyzed the age, sex distribution, physical examination outcomes, type and mechanism of injury, diagnosis, treatment and complications during surgery, postoperative follow-up, and time to return to play. The Lower Extremity Functional Scale (LEFS) and Marx scores were obtained at 3-month follow-up, and isokinetic tests were performed before return to sports. A telephone interview was completed to determine the presence of recurrence at an average follow-up of 18.2 months.ResultsAt 3-month follow-up, all patients had Marx activity scores of 16 and LEFS scores of 80. Return to the previous level of play occurred at a mean of 15.8 ± 2.6 weeks after surgery, and none of the athletes suffered a recurrence. Isokinetic test results were comparable between both sides.ConclusionThe surgical treatment of proximal rectus femoris avulsions, consisting of resection of the tendinous part of the muscle, is a reliable and safe technique allowing a fast recovery in professional athletes.

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Bicortical Titanium Tenodesis Button With Double-Row Fixation for the Treatment of Proximal Rectus Femoris Avulsion: Review of Literature and Surgical Technique.

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