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Biomechanical evaluation of different surgical techniques for treating patellar tendon ruptures

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Abstract

Purpose

The aim of this study was to biomechanically assess patellar tendon repair techniques with additional cable wire or polydioxanone suture (PDS) cord augmentation in comparison with a suture-anchor repair technique.

Methods

Patellar tendon repair was performed in 60 specimens using a porcine bone model. Yield load, maximum load, stiffness and elongation of patellar tendon reconstructions with (1) cable wire augmentation, (2) PDS cord augmentation or (3) suture anchor repair were evaluated using a cyclic loading and load-to-failure test setup.

Results

In comparison with suture anchor repair, augmentation of the reconstruction with either cable wires or PDS cords provides significantly higher maximum loads (527 and 460 N vs. 301 N; p < 0.01 and p = 0,012, respectively) under load-to-failure testing and less elongation (8.81 mm ± 1.55 mm and 10.56 mm ± 3.1 mm vs. 18.38 mm ± 7.51 mm; p = 0.037 and p = 0.033, respectively) under cyclic loading conditions.

Conclusion

Augmentation of a patellar tendon repair with either a cable wire or a PDS cord provides higher primary stability than suture anchor repair in patellar tendon ruptures. The study supports the use of additional augmentation of a tendon repair in the clinical setting in order to prevent loss of reduction and allow for early post-operative mobilisation.

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Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

All applicable international, national, and/or institutional guidelines for the care and use of animals were followed.

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Author notes

    Authors and Affiliations

    1. Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Albert-Schweitzer-Campus 1, Building W1, 48149, Münster, Germany

      Benedikt Schliemann, Niklas Grüneweller, Clemens Kösters, Simon Lenschow, Steffen B. Roßlenbroich, Michael J. Raschke & Andre Weimann

    2. Orthopaedic Clinic of the Hanover Medical School, Annastift Hospital, Anna-von-Borries Str. 1-7, 30625, Hannover, Germany

      Daiwei Yao

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    1. Benedikt Schliemann
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    2. Niklas Grüneweller
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    3. Daiwei Yao
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    4. Clemens Kösters
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    5. Simon Lenschow
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    6. Steffen B. Roßlenbroich
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    7. Michael J. Raschke
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    8. Andre Weimann
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    Correspondence to Benedikt Schliemann.

    Additional information

    Benedikt Schliemann and Niklas Grüneweller contributed equally to this work.

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    Schliemann, B., Grüneweller, N., Yao, D. et al. Biomechanical evaluation of different surgical techniques for treating patellar tendon ruptures. International Orthopaedics (SICOT) 40, 1717–1723 (2016). https://doi.org/10.1007/s00264-015-3003-4

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    • DOI: https://doi.org/10.1007/s00264-015-3003-4

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