Patellar Tendon Repair Augmentation With a Knotless Suture Anchor Internal Brace: A Biomechanical Cadaveric Study

Area of Science:

• Orthopedic surgery
• Biomechanical engineering
• Sports medicine

Background:

• Patellar tendon repair using braided polyethylene suture alone risks knot slippage and failure.
• Augmentation techniques are crucial for improving primary patellar tendon repair outcomes.
• A novel knotless suture anchor internal brace with suture tape (SAIB) offers a potential solution.

Purpose of the Study:

• To evaluate the biomechanical performance of a novel patellar tendon repair technique augmented with SAIB.
• To compare the SAIB-augmented repair against a non-augmented repair.
• To assess the SAIB-augmented repair's equivalence to standard augmentation using an 18-gauge steel wire.

Main Methods:

• Midsubstance patellar tendon tears were created in 32 human cadaveric knees.
• Two groups were established: (1) standard repair vs. SAIB-augmented repair, and (2) steel wire-augmented repair vs. SAIB-augmented repair.
• Biomechanical testing measured yield load, maximum load, and failure modes.

Main Results:

• SAIB augmentation significantly increased mean yield load (646 ± 202 N vs 229 ± 60 N) and maximum load (868 ± 162 N vs 365 ± 54 N) compared to standard repair alone (P < .001).
• No significant differences in biomechanical properties were found between SAIB-augmented repair and steel wire-augmented repair (P > .476).

Conclusions:

• Patellar tendon repair augmented with SAIB demonstrates superior biomechanical strength compared to non-augmented repair.
• The SAIB augmentation is biomechanically equivalent to traditional 18-gauge steel wire augmentation.
• SAIB offers a robust, single-stage augmentation for patellar tendon repair.