• Ronny Langenhan, Niklas Reimers, Petr Kohut, Axel Probst, Stefan Bushuven, Ludwig Schütz, and Milena Trifunovic-Koenig.
• Department of Orthopedic Surgery, Hegau-Bodensee-Klinikum Singen, Virchowstrasse 10, 78224, Singen, Germany. ronnyla@gmx.de.
• Arch Orthop Trauma Surg. 2025 Jan 25; 145 (1): 147147.

IntroductionMore 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.Materials And MethodsThis 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 of the International Knee Documentation Committee (IKDC) and Tegner-Lysholm Knee scores.ResultsThe participants ( mean 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 (p < 0.05). Smoking and suturing techniques showed no significant main 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.ConclusionsPatient-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.Evidence LevelIV-Retrospective cohort study without a comparison group.© 2025. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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