Tibial Eminence Avulsion Fracture Reduction With a Novel Adjustable-Loop Suture Repair Device: A Biomechanical...

Area of Science:

• Orthopedic surgery
• Biomechanical engineering
• Fracture repair

Background:

• Adjustable-loop devices (ALDs) are increasingly used for enhanced intraoperative repair stabilization.
• While ALDs are common in anterior cruciate ligament (ACL) procedures, their biomechanical benefit for tibial eminence avulsion fractures is less established.

Purpose of the Study:

• To biomechanically compare standard suture fixation with ALD-augmented suture fixation for tibial eminence avulsion fracture reduction.

Main Methods:

• Twenty porcine stifles underwent Type 3 tibial eminence avulsion fracture creation and repair using standard suture or ALD-assisted suture fixation.
• Repaired specimens were subjected to cyclic preconditioning, simulated intraoperative cycling, and cyclic loading (10-150 N) before pull-to-failure testing.

Main Results:

• The ALD group exhibited significantly less total cyclic elongation (0.76 mm vs. 5.50 mm) and higher ultimate load (532 N vs. 410 N) compared to the standard group.
• All constructs withstood cyclic loading, with no significant differences in cyclic stiffness between groups.

Conclusions:

• ALD addition to suture fixation for tibial eminence avulsion fractures significantly reduced cyclic elongation and increased ultimate load, indicating superior time-zero biomechanics.
• ALD fixation may improve healing by minimizing micromotion and loss of reduction, warranting further clinical investigation.