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The aim of this study was to evaluate midterm postoperative results including strength potential via standardized strength measurements after proximal rectus femoris tendon refixation. It was hypothesized that the majority of competitive athletes return to competition\u00a0(RTC) after refixation of the rectus femoris tendon without significant strength or functional deficits compared to the contralateral side.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with an acute (&lt;\u20096\u00a0weeks) PRFA who underwent surgical refixation between 2012 and 2019 with a minimum follow-up of 12\u00a0months were evaluated. The\u00a0outcome measures compiled were\u00a0the\u00a0median Tegner Activity Scale (TAS) and mean\u00a0RTC time frames, Harris Hip Score (HHS), Hip and Groin Outcome Score (HAGOS)\u00a0subscales, International Hip Outcome Tool-33 (iHOT-33), and\u00a0Visual Analog Scale (VAS)\u00a0for pain. In addition, a standardized isometric strength assessment of knee flexion, knee extension, and hip flexion was performed to evaluate the functional result of\u00a0the injured limb in\u00a0comparison to the uninjured side.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Out of 20 patients, 16 (80%) patients were available for final assessment at a mean follow-up of 44.8\u2009\u00b1\u2009SD 28.9\u00a0months. All patients were male with 87.5% sustaining\u00a0injuries while playing soccer. The average time interval between trauma and surgery was 18.4\u2009\u00b1\u20098.5\u00a0days. RTC was possible for 14 out of 15 previously competitive athletes (93.3%) at a mean 10.5\u2009\u00b1\u20093.4\u00a0months after trauma. Patients achieved a high level of activity postoperatively with a median (interquartile range) TAS of 9 (7\u20139) and reported good to excellent outcome scores (HHS: 100 (96\u2013100); HAGOS: symptoms 94.6 (89.3\u2013100), pain 97.5 (92.5\u2013100), function in daily living 100 (95\u2013100), function in sport and recreation 98.4 (87.5\u2013100), participation in physical activities 100 (87.5\u2013100), quality of life 83.1\u2009\u00b1\u200915.6; iHot-33: 95.1 (81.6\u201399.8)). No postoperative complications were reported. Range of motion, isometric knee flexion and extension, as well as hip flexion strength levels were not statistically different between the affected and contralateral legs. The majority of patients were \u201cvery satisfied\u201d (56.3%) or \u201csatisfied\u201d (37.5%) with the postoperative result and reported little pain (VAS 0 (0\u20130.5)).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Surgical treatment of acute PRFA yields excellent postoperative results in a young and highly active cohort. Hip flexion and knee extension strength was restored fully without major surgical complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>Retrospective cohort study; III.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00402-021-04189-0","type":"journal-article","created":{"date-parts":[[2021,10,19]],"date-time":"2021-10-19T02:51:21Z","timestamp":1634611881000},"page":"2263-2270","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Midterm outcome and strength assessment after proximal rectus femoris refixation in athletes"],"prefix":"10.1007","volume":"142","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2649-8420","authenticated-orcid":false,"given":"Maximilian","family":"Hinz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Geyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Winden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Braunsperger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Kreuzpointner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin D.","family":"Kleim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5085-6446","authenticated-orcid":false,"given":"Andreas B.","family":"Imhoff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian","family":"Mehl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,10,18]]},"reference":[{"key":"4189_CR1","doi-asserted-by":"publisher","first-page":"471","DOI":"10.1177\/1938640018819779","volume":"12","author":"HC B\u00e4cker","year":"2019","unstructured":"B\u00e4cker HC, Yenchak AJ, Trofa DP, Vosseller JT (2019) Strength measurement after achilles tendon repair. 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