Related Experiment Video
Updated: Dec 17, 2025
A Novel Tenorrhaphy Suture Technique with Tissue Engineered Collagen Graft to Repair Large Tendon Defects
Published on: December 10, 2021
An Isolated Transosseous Flexible Suture Frame in the Treatment of Patellar Tendon Rupture Provides Adequate
Pablo Besa1, Alberto Telias, Francisca Orrego
1From the Department of Orthopedic Surgery, Pontificia Universidad Católica de Chile (Dr. Besa, Dr. Irarrázaval, and Dr. M. Orrego), the School of Medicine, Universidad de Los Andes Santiago, Chile (Dr. F. Orrego and Dr. Cariola), the Department of Orthopedic Surgery, School of Medicine, Universidad de los Andes Santiago, Chile (Dr. Telias and Dr. Amenábar), and the Integrative Biomechanics and Physiology of Strain Laboratory (LIBFE), School of Kinesiology, Universidad de los Andes (Dr. Guzmán-Venegas and Mr. Palma), Santiago, Chile .
Introduction:
Acute patellar tendon ruptures are frequently observed in patients with metabolic comorbidities, and the benchmark treatment is surgical repair. It is desirable not to harm an already fragile biologic environment with sutures and hardware. We aimed to compare the mechanical requirements of an isolated, flexible, high-strength nonabsorbable transosseous suture frame with that of the Krackow suture technique.
Methods:
A total of 12 cadaveric pieces were randomized into two groups: the isolated flexible frame group (n = 6) and the standard Krackow fixation group (n = 6). A traumatic rupture of the patellar tendon was performed, and a transosseous displacement sensor was installed on a validated biomechanical system. Gap formation was measured during 50 cycles of flexion and extension with traction on the quadriceps (250 N). Subsequently, specimens underwent progressive loading in a fixed flexion position until failure occurred. The data were analyzed using nonparametric statistical tools with a significance level of 5%.
Results:
The isolated frame group had a smaller gap formation (1.7 mm) than the Krackow group (3.4 mm; P = 0.01). No significant difference existed in the median failure end points of the two groups (676 and 530 N, respectively; P = 0.11).
Discussion:
Patellar tendon repair using an isolated, transosseous, flexible, suture frame outperformed using the traditional Krakow repair technique in gap formation. Further studies are needed to determine if this will result in better functional outcomes or fewer clinical failures.
Level Of Evidence:
Level IV, experimental case series.
