No previous study has investigated poly-L-lactic acid (PLLA) surgical mesh augmentation
in the repair of inferior pole patellar tendon rupture. We compared the biomechanical
properties of transosseous patellar tendon repair with PLLA surgical mesh augmentation
to transosseous repair without augmentation. Ten matched pairs of cadaveric knees
were used. Specimens in each pair were randomized to undergo the transosseous technique
alone or the transosseous technique augmented with a PLLA surgical mesh. An inferior
pole patellar tendon rupture was simulated and the repair procedure was performed.
Specimens were cyclically loaded for 500 cycles. Gap formation was measured using
two sensors placed medial and lateral to the repair site. After cyclic loading, load
to failure was determined by pulling the tendon at a constant rate until a sudden
decrease in load occurred. The primary outcome measure was cyclic gap formation at
the medial and lateral sensors. Compared with controls, specimens that underwent PLLA
mesh-augmented repair had significantly lower medial gap formation at all testing
intervals up to 500 cycles (p < 0.05) and significantly lower lateral gap formation at all testing intervals from
10 to 500 cycles (p < 0.05). Transosseous patellar tendon repair augmented with a PLLA woven mesh device
provided significantly greater resistance to gap formation compared with transosseous
repair alone. These results suggest that PLLA mesh augmentation of the transosseous
technique is biomechanically effective for patellar tendon repair.
Keywords
patellar - tendon - poly-L-lactic acid - mesh - cadaveric - biomechanics
