Joseph T Lanzi1, Justin Felix2, Christopher J Tucker3, Kenneth L Cameron3, John Rogers2, Brett D Owens3, Steven J Svoboda3. 1. John A. Feagin Jr Sports Medicine Fellowship, Keller Army Hospital, United States Military Academy, West Point, New York, USA joseph.t.lanzi.mil@mail.mil joelanzi58@hotmail.com. 2. Department of Civil and Mechanical Engineering, United States Military Academy, West Point, New York, USA. 3. John A. Feagin Jr Sports Medicine Fellowship, Keller Army Hospital, United States Military Academy, West Point, New York, USA.
Abstract
BACKGROUND: Minimizing gap formation and maximizing the strength of patellar tendon repairs are 2 critical factors for successful healing of these injuries. PURPOSE/HYPOTHESIS: The purpose of this study was to compare transosseous and screw-in anchor repair techniques to determine if there is a difference in gap formation and load to failure of the 2 constructs. The research hypotheses were that the anchor construct would have significantly less gap formation and would also have significantly greater load-to-failure strength. STUDY DESIGN: Controlled laboratory study. METHODS: A total of 24 porcine specimens were randomly assigned into transosseous and 4.75-mm polyetheretherketone (PEEK) screw-in anchor repair groups. The repairs were then completed using 2 No. 2 FiberWire sutures, and each specimen was cyclically loaded on a tensile test machine to 250 N for a total of 1000 cycles. Gap formation was measured at 1, 10, 250, 500, and 1000 cycles. Each specimen was loaded to failure after 1000 cycles. Independent t tests were conducted. RESULTS: Statistically significant gap formation and load-to-failure differences were found between the 2 repair techniques. The mean gap in the anchor group (2.16 ± 1.81 mm) was significantly less than that seen in the transosseous group (5.71 ± 1.58 mm) (P < .001). The mean load to failure of the anchor group (669.9 ± 91.8 N) was significantly higher than that of the transosseous group (582.8 ± 92.6 N) (P = .03). CONCLUSION: The results support the 2 study hypotheses. These findings suggest that the 4.75-mm PEEK screw-in anchor construct may be superior to the transosseous technique for minimizing gap formation and improving load-to-failure strength after surgical repair of the patellar tendon. CLINICAL RELEVANCE: The use of the suture anchor technique in patellar tendon repair may support early load-bearing rehabilitation.
BACKGROUND: Minimizing gap formation and maximizing the strength of patellar tendon repairs are 2 critical factors for successful healing of these injuries. PURPOSE/HYPOTHESIS: The purpose of this study was to compare transosseous and screw-in anchor repair techniques to determine if there is a difference in gap formation and load to failure of the 2 constructs. The research hypotheses were that the anchor construct would have significantly less gap formation and would also have significantly greater load-to-failure strength. STUDY DESIGN: Controlled laboratory study. METHODS: A total of 24 porcine specimens were randomly assigned into transosseous and 4.75-mm polyetheretherketone (PEEK) screw-in anchor repair groups. The repairs were then completed using 2 No. 2 FiberWire sutures, and each specimen was cyclically loaded on a tensile test machine to 250 N for a total of 1000 cycles. Gap formation was measured at 1, 10, 250, 500, and 1000 cycles. Each specimen was loaded to failure after 1000 cycles. Independent t tests were conducted. RESULTS: Statistically significant gap formation and load-to-failure differences were found between the 2 repair techniques. The mean gap in the anchor group (2.16 ± 1.81 mm) was significantly less than that seen in the transosseous group (5.71 ± 1.58 mm) (P < .001). The mean load to failure of the anchor group (669.9 ± 91.8 N) was significantly higher than that of the transosseous group (582.8 ± 92.6 N) (P = .03). CONCLUSION: The results support the 2 study hypotheses. These findings suggest that the 4.75-mm PEEK screw-in anchor construct may be superior to the transosseous technique for minimizing gap formation and improving load-to-failure strength after surgical repair of the patellar tendon. CLINICAL RELEVANCE: The use of the suture anchor technique in patellar tendon repair may support early load-bearing rehabilitation.
Authors: Ryan O'Donnell; Nicholas J Lemme; Stephen Marcaccio; Devin F Walsh; Kalpit N Shah; Brett D Owens; Steven F DeFroda Journal: Orthop J Sports Med Date: 2021-08-16
Authors: Patrick A Massey; Mitchell Myers; Kaylan McClary; Jimmy Brown; R Shane Barton; Giovanni F Solitro Journal: Orthop J Sports Med Date: 2020-10-02