Biomechanical comparison of repair and augmentation techniques in patellar tendon ruptures

PURPOSE: The aim of this study is to biomechanically compare the augmentation techniques used in the surgical treatment of patellar tendon ruptures. MATERIAL AND METHODS: The study was carried out with sixty fresh-frozen bovine knees. Patellar tendon repair was performed with transosseous repair with Krackow or modified - Kessler suturing or suture anchor repair techniques. Dall-Miles cable, cerclage wire or polyester suture material was used for augmentation. each specimen was evaluated biomechanically by cyclic loading and static pullout tests. RESULTS: Significantly lower cyclic elongation values were recorded in the transosseous repair with Krackow suture group (p <0.05) in the comparison of primary repair groups. Lower cyclic elongation and higher maximal tensile strength values were measured in the augmentation with Dall-Miles cable or cerclage wire groups than the other groups. Augmentation groups had higher maximal tensile strength values and lower gap formation than non-augmented groups. CONCLUSIONS: In the surgical treatment of patellar tendon ruptures, augmentation biomechanically strengthens the initial stability of primary repair. The transosseous repair augmented with the Dall-Miles cable or cerclage wire can be said to be the most biomechanically stabilizing technique