Return to sport after acute patellar tendon repair: identifying key prognostic factors.

PURPOSE: To answer three clinically oriented questions after acute patellar tendon repair: how often and how quickly patients return to sport (RTS), which patient factors are associated with RTS, and whether repair technique is associated with RTS under a common surgical and rehabilitation protocol. METHODS: Single-centre retrospective cohort of 46 consecutive adults treated for acute complete patellar tendon rupture at a public university hospital (2014-2022). Repairs were performed by a single surgeon using either suture anchors (n = 25) or transosseous tunnels (n = 21); technique availability was determined by hospital tendering/procurement processes. Outcomes were time to RTS and RTS by last follow-up. Analyses were descriptive, with simplified adjusted models for age, sex, body mass index (BMI), comorbidity, pre-injury sport impact, and repair technique. RESULTS: Overall, 87.0% (40/46) returned to sport at a mean of 5.88 +/- 0.35 months. Higher BMI was associated with slower RTS (HR 0.82 per +5 kg/m2; 95% CI 0.68-0.99; p = 0.041) and lower odds of RTS (OR 0.62 per +5 kg/m2; 95% CI 0.39-0.98; p = 0.042). Age showed a non-significant trend toward slower RTS. Descriptive comparisons showed no significant between-technique differences in postoperative outcomes. CONCLUSIONS: Most patients resumed sport during the first postoperative semester. BMI, and less consistently age, appeared more relevant to RTS prognosis than the choice between anchor- and tunnel-based repair, although the small sample size requires cautious interpretation. LEVEL OF EVIDENCE: III; retrospective cohort study.