¹Hegau-Bodensee-Klinikum Singen, Singen, Deutschland
²Klinikum Chemnitz gGmbH, Klinik für Orthopädie, Unfall- und Handchirurgie, Chemnitz, Deutschland
³DIAKOMED – Diakoniekrankenhaus Chemnitzer Land gGmbH, Klinik für Orthopädie und Unfallchirurgie, Hartmannsdorf, Deutschland
⁴Hegau-Bodensee-Klinikum Singen im Gesundheitsverbund Landkreis Konstanz, Klinik für Klinik für Orthopädie, Unfall- und Handchirurgie, Singen, Deutschland
⁵Institute for Infection Control and Infection Prevention, Hegau-Jugendwerk Gailingen, Gailingen, Deutschland
⁶Training Center for Emergency Medicine (NOTIS e.V), Engen, Deutschland

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Objectives and questions: More extensive and cohesive studies on quadriceps tendon rupture (QTR) repair surgery are required to guide effective treatment strategies. Therefore, in this study, we aimed to identify predictors of subjective functional recovery following QTR repair surgery.

Material and methods: This multicentre retrospective cohort study enrolled 191 adults (age ≥ 18 years) who underwent surgical unilateral QTR repair (2010–2022) and had ≥ 1-year postoperative follow-up at three trauma centres in Germany. Multiple linear regression and moderation analyses evaluated seven patient-centred factors and eight treatment-related predictors on the International Knee Documentation Committee (IKDC) and Tegner–Lysholm Knee Scores.

Results: The participants (average age = 62.3 years) had mean (standard deviation) IKDC and Tegner–Lysholm Knee Scores of 67.4 (19.4) and 74.8 (22.5), respectively. Male sex, lower body mass index (BMI), shorter time to surgery, and early rehabilitation adoption predicted higher functional scores (<em>p </em>< 0.05). Smoking and suturing techniques showed no significant effects. Age was negatively correlated with IKDC scores when transosseous sutures were applied but not when suture anchors were used. Notably, 6% of the cohort were affected by complications such as re-rupture or deep vein thrombosis.

Discussion and conclusion: Patient-centred factors (sex and BMI) and treatment-related factors (timing of surgery and rehabilitation protocols) significantly influence postoperative functional outcomes in patients with QTR. Early surgical intervention and dynamic rehabilitation protocols are important for optimising recovery, and suture anchor techniques may be advantageous in older patients. Further research is essential to improve QTR management strategies and enhance patient outcomes.