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      The increasing incidence of surgically treated quadriceps tendon ruptures

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          Abstract

          Purpose

          Due to increased life expectancy and a more active life style of the older people, we hypothesised that the incidence of quadriceps tendon rupture (QTR) is higher than previously reported. The objective of this nationwide population-based study was to investigate the annual incidence of QTR in patients who underwent operative treatment in Finland between 1997 and 2014.

          Methods

          The Finnish National Hospital Discharge Register was searched for all adult patients who had undergone surgical treatment for QTR during the study period. Population-based annual incidence and incidence trends for surgically treated QTR were calculated.

          Results

          During the study period, 1343 QTR surgeries were performed. Of these, 90% were performed on male patients. The incidence of QTR increased by 411% from 0.55 to 2.82 per 100,000 person-years from 1997 to 2014. The average yearly increase in the number of surgeries was 9.0%. In male patients, the incidence of QTR increased by 490% and in female patients by 121%. The mean age of the male patients increased during the study period from 50 to 59 years.

          Conclusions

          Based on the data from the Finnish National Hospital Discharge Register, the annual incidence of QTR increased by over 400% during the 18-year study period. The average age of the patients also increased. Because QTR is only very rarely treated without surgery, the results of our study can be considered to be a reliable estimate of the increase in the incidence of this condition. There is an urgent need to establish the risk factors associated with QTR and to also establish the optimal surgical technique.

          Level of evidence

          IV.

          Electronic supplementary material

          The online version of this article (10.1007/s00167-019-05453-y) contains supplementary material, which is available to authorized users.

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          Most cited references18

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          Distal biceps tendon ruptures: incidence, demographics, and the effect of smoking.

          The purpose of the current study was to determine the incidence of distal biceps tendon ruptures within a defined population, to describe the demographics of affected individuals, and to identify potential risk factors. The healthcare system in this study provides care to a known number of members in an area defined by zip codes and proximity to the medical center. Medical records for all members who presented with injuries about the elbow during a 5-year period were reviewed. Thirteen men and one woman with an average age of 47 years comprised the study population. The dominant extremity was involved in 86% of patients. All patients described a mechanism involving excessive eccentric tension as the arm was forced from a flexed position. The incidence of injury in the membership population averaged 1.2 ruptures per 100,000 patients per year. Forty-three percent reported regular tobacco use, whereas only 9% of all members were smokers. A Poisson regression analysis revealed a 7.5 times greater risk of distal biceps tendon rupture in patients who smoke. The incidence of distal biceps tendon ruptures is 1.2 per 100,000 patients, with the majority in the dominant elbow of men who smoke and who are in their fourth decade of life.
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            The epidemiology of Achilles tendon rupture in a Danish county.

            The epidemiology of Achilles tendon ruptures was examined during the 13-year period 1984-1996 in a Danish county. Five hospitals, serving a population of 220,000 cooperated. There were 718 ruptures, 544 men (75.8%) and 174 women (24.2%). The male to female ratio was 3:1. The average age was 42.1 years (3-82) and 62% were between 30-49 years. 74.2% of the ruptures were sport-related and 89% of these occurred in ball and racket games. The annual incidence of achilles tendon ruptures increased from 18.2/10(5) inhabitants in 1984 to 37.3/10(5) in 1996. The peak incidence in sport-related ruptures occurred in the age group 30-49 years, but ruptures not related to sport occurred in older patients with a peak incidence in those 50-59 years.
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              Distal Biceps Tendon Ruptures: An Epidemiological Analysis Using a Large Population Database.

              The incidence of distal biceps tendon ruptures was studied more than 10 years ago in a small patient cohort. Recent diagnostic advancements have improved the ability to detect this rare injury.
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                Author and article information

                Contributors
                +358 14 269 3 168 , aleksi@reito.fi
                Journal
                Knee Surg Sports Traumatol Arthrosc
                Knee Surg Sports Traumatol Arthrosc
                Knee Surgery, Sports Traumatology, Arthroscopy
                Springer Berlin Heidelberg (Berlin/Heidelberg )
                0942-2056
                1433-7347
                27 March 2019
                27 March 2019
                2019
                : 27
                : 11
                : 3644-3649
                Affiliations
                [1 ]GRID grid.460356.2, ISNI 0000 0004 0449 0385, Central Finland Central Hospital, ; Keskussairaalantie 19, 40620 Jyvaskyla, Finland
                [2 ]GRID grid.9668.1, ISNI 0000 0001 0726 2490, Institute of Clinical Medicine, , University of Eastern Finland, ; Yliopistonranta 1, 70210 Kuopio, Finland
                [3 ]GRID grid.412330.7, ISNI 0000 0004 0628 2985, Department of Orthopaedics, Unit of Musculoskeletal Surgery, , Tampere University Hospital, ; Teiskontie 35, 33521 Tampere, Finland
                [4 ]GRID grid.502801.e, ISNI 0000 0001 2314 6254, School of Medicine, , University of Tampere, ; 33014 Tampere, Finland
                Author information
                http://orcid.org/0000-0002-6903-6461
                Article
                5453
                10.1007/s00167-019-05453-y
                6800863
                30919003
                7d306bb0-7e86-46a1-99ef-531df0c3ea6f
                © The Author(s) 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                : 11 October 2018
                : 27 February 2019
                Categories
                Knee
                Custom metadata
                © European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2019

                Surgery
                quadriceps tendon,tendon rupture,registry study,epidemiology,incidence
                Surgery
                quadriceps tendon, tendon rupture, registry study, epidemiology, incidence

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