Biomechanical Properties of Suture Anchor Repair Compared With Transosseous Sutures in Patellar Tendon Ruptures

Abstract

These findings may be of relevance for future clinical treatment of patellar tendon ruptures. Randomized controlled clinical trials comparing suture anchors to transosseous suture repair are desirable.

Novel Augmentation Technique for Patellar Tendon Repair Improves Strength and Decreases Gap Formation: A Cadaveric Study

“…Despite routine use of the transosseous tunnel and modified-Krackow suture technique, little is known about the biomechanical properties of this repair method. Alternative fixation options such as suture anchors and various augmentation techniques have been described but supported with limited biomechanical evidence [3,7,13,15,16,23,30,36,40]. Our study provides a better understanding of the gap formation that can occur after patellar tendon repair and our proposed augmentation technique showed a substantial decrease in gap formation and an increase in ultimate strength of the repair compared with a common repair technique.…”

“…Despite having a decrease in gap formation with suture anchors, there was no difference in load to failure between the different techniques. In a similar study by Ettinger et al [7], maximum load to failure for titanium and hydroxyapatite suture anchors was reported to be 597 N and 689 N, respectively. For transosseous suture repair, the maximum load to failure was 301 N. However, they performed a modified transosseous suture repair using Number 2 Ultrabraid TM (Smith & Nephew, Memphis, TN, USA) suture with the knots tied at the patellar tendon end, rather than over the superior pole of the patella.…”

“…Prompt surgical repair of patellar tendon ruptures is preferred in patients fit for surgery to restore the extensor mechanism and allow optimal return to function [22,28,37], but studies disagree about the best surgical technique [7,11,15,[25][26][27][28]. Despite routine use of the transosseous tunnel and modified-Krackow suture technique, little is known about the biomechanical properties of this repair method.…”

“…Despite numerous small retrospective studies that exist describing patellar tendon repairs with and without augmentation, standardized evaluation of the repairs is lacking and no clinical trials exist comparing different repair methods. Only more recently have biomechanical studies appeared which systematically compare the strength and efficacy of various techniques, but the preferred repair method often is debated [3,7,19,35]. Additionally, the role of gap formation across a repair and the loads experienced by the repair before catastrophic failure are not well defined.…”

CORR Insights®: Novel Augmentation Technique for Patellar Tendon Repair Improves Strength and Decreases Gap Formation: A Cadaveric Study

“…Although several studies have described patellar tendon repairs with and without augmentation, we really do not know which approach is better. Biomechanical studies have compared the efficacy of various techniques, but a consensus regarding the preferred repair method could not be reached [2,5,7,11].…”