Background Patellar tendon rupture is an uncommon but functionally debilitating injury requiring prompt surgical repair to restore the knee extensor mechanism. Evidence regarding the effect of short in-hospital delays to surgery on postoperative outcomes remains limited. This study evaluated short-term clinical outcomes following acute patellar tendon repair at a tertiary trauma centre over a 16-year period. Methods A retrospective case series was conducted using a prospectively maintained trauma registry from a tertiary hospital in the East Midlands, United Kingdom (2008-2024). Clinical records, operative notes, and follow-up documentation were reviewed. Data collected included patient demographics, injury characteristics, imaging modality, repair technique, surgeon grade, time to surgery (TTS), postoperative range of motion (ROM), follow-up duration, and complications. The primary outcome was postoperative knee flexion ROM at discharge. Statistical analysis included Pearson correlation and Spearman's correlation for non-parametric analysis, independent-samples t-tests, and one-way ANOVA. Results Thirty-four patients underwent operative repair of acute patellar tendon rupture. The cohort had a male-to-female ratio of 7.5:1, with a mean age of 50.7 years. Mean TTS was 2.5 days, and mean postoperative ROM at discharge was 105.4°. All patients with documented range-of-motion data achieved at least 85° of knee flexion, recorded at the final outpatient review. Complications occurred in nine (26.5%) patients, although most were minor and managed non-operatively. There was no significant association between TTS and postoperative ROM at discharge (r = -0.11, p = 0.59), suggesting that short in-hospital delays within the observed acute treatment window were not statistically associated with ROM at discharge. No statistically significant differences in short-term outcomes were observed between consultant-led and supervised registrar-led procedures, although this comparison was exploratory and unadjusted. Additional preoperative imaging was not associated with a statistically significant increase in TTS. Conclusion Primary repair of acute patellar tendon rupture produced satisfactory short-term functional outcomes with a low rate of major complications. Within the observed acute treatment window (0-9 days), no association was identified between time to surgery and knee flexion ROM at discharge, although the study was underpowered to exclude small-to-moderate effects. Supervised trainee-led surgery was associated with short-term outcomes similar to those of consultant-led procedures, although case allocation was not randomised. These findings are exploratory and confined to short-term outcomes. Larger prospective studies incorporating validated patient-reported outcome measures are required to better define prognostic factors following acute patellar tendon repair.
Bencharles et al. (Fri,) studied this question.