Acute repair of disruptions of the knee extensor mechanism is indicate
d to reestablish extensor continuity and allow for early motion. This
study reviews the results of acute primary repair of patellar tendon r
uptures augmented by a nonabsorbable polyester tape (Mersilene; Ethico
n, Inc.) followed by immediate mobilization. Twenty-four patients with
disruptions of their patellar tendons were treated using the describe
d technique. The ruptured tendon was initially approximated using an e
nd-to-end suture repair with no. 5 Ticron suture in a whipstitch manne
r. An O Vicryl suture was used to approximate the free tendon edges. A
5-mm Mersilene tape was then used in a cerclage manner to augment and
protect the repair. Postsurgery, passive range of motion (ROM) was be
gun immediately in the knees with isolated injury or in those patients
whose concomitant injuries would allow for early motion. Using clinic
al and radiographic criteria, follow-up evaluations of 19 patients wer
e performed at an average of 22.4 months. In patients with isolated in
juries, active ROM was from 0 degrees extension to 132 degrees flexion
(contralateral knee 0-135 degrees). Two patients had prominent knots;
in one, the knots were painful and were removed surgically. Six patie
nts developed patellofemoral chondrosis. Five patients had the Mersile
ne tape tied with the knee in full extension, and all developed patell
ofemoral pain. The other repairs were done with the knee flexed to 90
degrees before tying; one patient in this group developed patellofemor
al symptoms. All patients with isolated injuries have returned to empl
oyment. There were no reruptures or infections. Acute repair of patell
ar tendon disruptions using a whipstitch suture for primary stabilizat
ion and a woven polyester tape as augmentation is reliable. The techni
que allows for early motion and in most cases obviates the need for se
condary removal of the fixation device. Proper tensioning of the tape
can be assured if the knee is flexed 90 degrees at the time of augment
ation, which preserves the functional length of the patellar tendon an
d may diminish the likelihood of patellofemoral symptoms.