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Retensionable All-Suture Anchor Extensor Mechanism Repair
Zachary S Aman1, Samuel G Lorentz1, Robert T Tisherman1
1Department of Orthopedic Surgery, Duke University, Durham, North Carolina, USA.
Video Journal of Sports Medicine
|June 19, 2026
Summary
Knotless retensionable all-suture anchors provide a strong, adjustable option for extensor mechanism repairs. This technique offers improved biomechanics and potentially fewer complications compared to traditional methods for quadriceps and patellar tendon ruptures.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Sports Medicine
Background:
- Extensor mechanism tendon ruptures (quadriceps and patellar) are severe injuries requiring surgical repair.
- Current repair techniques include suture anchor and transosseous methods, with reported failure rates up to 21%.
- There is a need for improved repair strategies to enhance outcomes and reduce failure rates.
Purpose of the Study:
- To describe and evaluate a novel surgical technique for extensor mechanism repair using knotless retensionable all-suture anchors.
- To assess the biomechanical advantages and clinical outcomes of this technique.
Main Methods:
- The technique involves creating transosseous tunnels and utilizing retensionable all-suture anchor loops.
- Sutures are passed through the tendon with Krakow stitches and secured via anchors.
- The construct is tensioned and adjusted to reduce the tendon and minimize creep.
Main Results:
- Knotless retensionable all-suture anchors demonstrated superior biomechanical properties compared to traditional repairs.
- This method showed significantly less gap formation, higher load-to-failure, and greater stiffness.
- Adjustable anchors allowed for intraoperative and postoperative retensioning, minimizing laxity and enabling earlier motion.
Conclusions:
- Transosseous retensionable all-suture anchors represent a high-strength alternative for extensor mechanism repairs.
- This technique offers advantages in minimizing creep and potentially reducing complications associated with hardware.
- The adjustability of the anchors may lead to improved patient outcomes and faster rehabilitation.
