Suture anchor repair yields better biomechanical properties than transosseous sutures in ruptured quadriceps tendons

Abstract

Not applicable, controlled laboratory human cadaveric study.

The utility of electrocautery for suture passage through bone: A biomechanical study

“…To keep tissue approximated to bone, holes are frequently placed into bone through which suture, wire, screws, or suture anchors are passed or placed. Bone preparation is typically performed with power drills, tunneling devices, or awls . A novel surgical technique in orthopedics involves the use of electrosurgery to facilitate passage of a suture needle through bone without the aid of a drill hole .…”

Knotless Tape Suture Fixation of Quadriceps Tendon Rupture: A Novel Technique

“…[1][2][3][4][5]12,17,19 The standard of care is passage of nonabsorbable sutures through transosseous patellar bone tunnels, but repair with suture anchors has been studied as an alternative that allows for less tissue trauma, decreased operative time, safe early initiation of rehabilitation protocols, and reduced risk of patella fracture or damage. 3,7,[10][11][12][18][19][20]21,23 Despite these potential advantages, biomechanical studies have yielded inconsistent results regarding the superiority of suture anchor repair over repair with transosseous tunnels. 7,[10][11][12][18][19][20] We propose quadriceps tendon repair using the 4.75-mm biocomposite knotless suture anchor with tape suture technique as a biomechanically superior alternative to either transosseous tunnels or suture anchor repair alone, with significant advantages both in and out of the operating room.…”

“…1 It most often occurs in male, middle-aged or older patients with degenerative tendon changes and serious systemic diseases, such as chronic renal failure, diabetes mellitus, rheumatoid arthritis, and disorders requiring long-term steroid use (tissue quality is often compromised by patient age and comorbidities). [2][3][4][5][6][7][8][9][10] Whereas partial tears with an intact extensor mechanism may be managed nonoperatively, prompt operative intervention is indicated in cases of complete tear or an incompetent extensor mechanism to facilitate early range of motion (ROM) and return of knee function. [2][3][4]8,9 The standard of care is repair with a nonabsorbable suture passed through transosseous patellar tunnels, often with several weeks of postoperative immobilization to protect the repair.…”

“…[2][3][4]8,9 The standard of care is repair with a nonabsorbable suture passed through transosseous patellar tunnels, often with several weeks of postoperative immobilization to protect the repair. 3,4,7,[10][11][12] Reported complications of this method include significant extension lag, decreased strength, and ROM compared with the contralateral knee, chronic pain, and iatrogenic patellar fracture. 8,[13][14][15][16][17][18] Repair techniques using suture anchors have been proposed as viable alternatives, but biomechanical studies comparing them with standard transosseous repair have reported mixed results.…”

“…8,[13][14][15][16][17][18] Repair techniques using suture anchors have been proposed as viable alternatives, but biomechanical studies comparing them with standard transosseous repair have reported mixed results. 7,[10][11][12][18][19][20] Two studies found improved biomechanical characteristics with suture anchors, 10,21 but 2 others found the characteristics of suture anchor fixation equal to 11 or worse than 12 those of transosseous fixation.…”