COMPARATIVE STUDY
JOURNAL ARTICLE

Biomechanical properties of suture anchor repair compared with transosseous sutures in patellar tendon ruptures: a cadaveric study

Max Ettinger, Antonios Dratzidis, Christof Hurschler, Stephan Brand, Tilman Calliess, Christian Krettek, Michael Jagodzinski, Maximilian Petri
American Journal of Sports Medicine 2013, 41 (11): 2540-4
23982397

BACKGROUND: Ruptures of the patellar tendon are debilitating injuries requiring surgical repair. Reliable data about the most appropriate suture technique and suture material are missing. The standard procedure consists of refixing the tendon with sutures in transpatellar tunnels, sometimes combined with augmentation.

HYPOTHESIS: Suture anchors provide at least equal results concerning gap formation during cyclic loading and ultimate failure load compared with transosseous suture repair.

STUDY DESIGN: Controlled laboratory study.

METHODS: A total of 30 human cadaveric patellar tendons underwent tenotomy followed by repair with 5.5-mm titanium suture anchors, 5.5-mm resorbable hydroxyapatite suture anchors, or transpatellar suture tunnels with No. 2 Ultrabraid and the Krackow whipstitch technique. Biomechanical analysis included pretensioning the constructs at 20 N for 30 seconds and then cyclic loading of 250 cycles between 20 and 100 N at 1 Hz in a servohydraulic testing machine with measurement of elongation. After this, ultimate failure load and failure mode analysis was performed.

RESULTS: Compared with transosseous sutures, tendon repairs with suture anchors yielded significantly less gap formation during cyclic loading (P < .05) and resisted significantly higher ultimate failure loads (P < .05). Common failure mode was pullout of the eyelet within the suture anchor in the hydroxyapatite anchor group and rupture of the suture in the titanium anchor group and-at lower load to failure-in the transosseous group.

CONCLUSION: Patellar tendon repair with suture anchors yields significantly better biomechanical results than repair with the commonly applied transosseous sutures.

CLINICAL RELEVANCE: 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.

Full Text Links

Find Full Text Links for this Article

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read
23982397
×

Save your favorite articles in one place with a free QxMD account.

×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"