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J Knee Surg 2024; 37(03): 193-197
DOI: 10.1055/s-0043-1766094
Original Article

Biomechanical Comparison of Four- versus Six-Strand Transosseous Suture Repair for Patellar Tendon Rupture

Tina Zhang 
1   Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland
,
Alexander Wahl
1   Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland
,
Matheus Schneider
1   Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland
,
Dali Xu
2   Physical Therapy and Rehabilitation Science, University of Maryland, Baltimore, Maryland
,
Alexander Hahn
1   Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland
,
Sean J. Meredith
1   Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland
,
Jonathan D. Packer
1   Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland
,
Natalie L. Leong 
1   Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland
,
Li-Qun Zhang
1   Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland
2   Physical Therapy and Rehabilitation Science, University of Maryland, Baltimore, Maryland
,
R. Frank Henn III
1   Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland
,
Julio J. Jauregui
1   Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland
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Abstract

Background Surgical repair is indicated for patellar tendon ruptures that result in loss of knee extensor mechanism function. However, biomechanical studies report conflicting results when comparing transosseous suture versus suture anchor repair techniques. This discrepancy may be due to inconsistencies in experimental design as these studies use various numbers of suture strands. Therefore, the main objective of this study is to compare the ultimate load of four- versus six-strand transosseous suture repair. Secondary objectives are to compare gap formation after cyclical loading and mode of failure.

Methods Six pairs of fresh-frozen cadaveric specimen were randomly allocated to either four- or six-strand transosseous suture repair. Specimen underwent preconditioning cyclical loading and then load to failure.

Results The six-strand repair had a significantly higher maximum load to failure compared with the four-strand repair (mean difference = 319.3 N [57.9%], p = 0.03). There was no significant difference in gap length after cyclical loading or at max load. There were no significant differences in mode of failure.

Conclusion Utilizing a six-stand transosseous patella tendon repair construct with one additional suture increases overall construct strength by over 50% compared with a four-strand construct.

Keywords

biomechanics - patellar tendon rupture - transosseous fixation - patellar tendon repair


Publication History

Received: 24 October 2022

Accepted: 12 February 2023

Article published online:
06 April 2023

© 2023. Thieme. All rights reserved.

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