title: Comparison of the Suture Anchor and Transosseous Techniques for Patellar Tendon Repair: A Biomechanical Study.
abstract: Minimizing gap formation and maximizing the strength of patellar tendon repairs are 2 critical factors for successful healing of these injuries.
  
  
  
  The purpose of this study was to compare transosseous and screw-in anchor repair techniques to determine if there is a difference in gap formation and load to failure of the 2 constructs. The research hypotheses were that the anchor construct would have significantly less gap formation and would also have significantly greater load-to-failure strength.
  
  
  
  Controlled laboratory study.
  
  
  
  A total of 24 porcine specimens were randomly assigned into transosseous and 4.75-mm polyetheretherketone (PEEK) screw-in anchor repair groups. The repairs were then completed using 2 No. 2 FiberWire sutures, and each specimen was cyclically loaded on a tensile test machine to 250 N for a total of 1000 cycles. Gap formation was measured at 1, 10, 250, 500, and 1000 cycles. Each specimen was loaded to failure after 1000 cycles. Independent t tests were conducted.
  
  
  
  Statistically significant gap formation and load-to-failure differences were found between the 2 repair techniques. The mean gap in the anchor group (2.16 ± 1.81 mm) was significantly less than that seen in the transosseous group (5.71 ± 1.58 mm) (P < .001). The mean load to failure of the anchor group (669.9 ± 91.8 N) was significantly higher than that of the transosseous group (582.8 ± 92.6 N) (P = .03).
  
  
  
  The results support the 2 study hypotheses. These findings suggest that the 4.75-mm PEEK screw-in anchor construct may be superior to the transosseous technique for minimizing gap formation and improving load-to-failure strength after surgical repair of the patellar tendon.
  
  
  
  The use of the suture anchor technique in patellar tendon repair may support early load-bearing rehabilitation.
authors.affiliation: John A. Feagin Jr Sports Medicine Fellowship, Keller Army Hospital, United States Military Academy, West Point, New York, USA joseph.t.lanzi.mil@mail.mil joelanzi58@hotmail.com.
authors.forename: Joseph T
authors.initials: JT
authors.lastname: Lanzi
authors.affiliation: Department of Civil and Mechanical Engineering, United States Military Academy, West Point, New York, USA.
authors.forename: Justin
authors.initials: J
authors.lastname: Felix
authors.affiliation: John A. Feagin Jr Sports Medicine Fellowship, Keller Army Hospital, United States Military Academy, West Point, New York, USA.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Tucker
authors.affiliation: John A. Feagin Jr Sports Medicine Fellowship, Keller Army Hospital, United States Military Academy, West Point, New York, USA.
authors.forename: Kenneth L
authors.initials: KL
authors.lastname: Cameron
authors.affiliation: Department of Civil and Mechanical Engineering, United States Military Academy, West Point, New York, USA.
authors.forename: John
authors.initials: J
authors.lastname: Rogers
authors.affiliation: John A. Feagin Jr Sports Medicine Fellowship, Keller Army Hospital, United States Military Academy, West Point, New York, USA.
authors.forename: Brett D
authors.initials: BD
authors.lastname: Owens
authors.affiliation: John A. Feagin Jr Sports Medicine Fellowship, Keller Army Hospital, United States Military Academy, West Point, New York, USA.
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Svoboda
mesh_terms: D000818:Animals; D001696:Biomechanical Phenomena; D001863:Bone Screws; D006801:Humans; D017847:Patellar Ligament / Q000293:injuries* / Q000502:physiology / Q000601:surgery*; D011897:Random Allocation; D053441:Suture Anchors; D013536:Suture Techniques; D013552:Swine; D013718:Tensile Strength; D016474:Weight-Bearing; D014945:Wound Healing
keywords: gap; knee; load to failure; patellar tendon; rehabilitation; suture anchor; tensile test; transosseous; ultimate load