Abstract
Quadriceps rupture off the patella is traditionally repaired by a transosseous tunnel
technique, although a single-row suture anchor repair has recently been described.
This study biomechanically tested a new transosseous equivalent (TE) double-row suture
anchor technique compared with the transosseous repair for quadriceps repair. After
simulated quadriceps-patella avulsion in 10 matched cadaveric knees, repairs were
completed by either a three tunnel transosseous (TT = 5) or a TE suture anchor (TE = 5)
technique. Double-row repairs were done using two 5.5 Bio-Corkscrew FT (fully threaded)
(Arthrex, Inc., Naples, FL, USA) and two 3.5 Bio-PushLock anchors (Arthrex, Inc.,
Naples, FL, USA) with all 10 repairs done with #2 FiberWire suture (Arthrex, Inc.,
Naples, FL). Cyclic testing from 50 to 250 N for 250 cycles and pull to failure load
(1 mm/s) were undertaken. Gap formation and ultimate tensile load (N) were recorded
and stiffness data (N/mm) were calculated. Statistical analysis was performed using
a Mann–Whitney U test and survival characteristics examined with Kaplan–Meier test. No significant
difference was found between the TE and TT groups in stiffness (TE = 134 ± 15 N/mm,
TT = 132 ± 26 N/mm, p = 0.28). The TE group had significantly less ultimate tensile load (N) compared with
the TT group (TE = 447 ± 86 N, TT = 591 ± 8 4 N, p = 0.04), with all failures occurring at the suture eyelets. Although both quadriceps
repairs were sufficiently strong, the transosseous repairs were stronger than the
TE suture anchor repairs. The repair stiffness and gap formation were similar between
the groups.
Keywords
quadriceps tendon repair - transosseous equivalent repair
