title: Knotless Suture Anchor With Suture Tape Quadriceps Tendon Repair Is Biomechanically Superior to Transosseous and Traditional Suture Anchor-Based Repairs in a Cadaveric Model.
abstract: OBJECTIVE
  To compare the biomechanical properties of a knotless suture anchor with suture tape quadriceps tendon repair technique with transosseous and suture anchor repair techniques.
  
  
  METHODS
  Twenty matched pairs of cadaveric knees underwent a quadriceps tendon avulsion followed by repair via the use of transosseous tunnels with #2 high-strength sutures, 5.5-mm biocomposite fully threaded suture anchors with #2 high-strength sutures, or 4.75-mm biocomposite knotless suture anchors with suture tape. Ten knees were repaired via transosseous repair and 10 via fully threaded suture anchor repair, and their matched specimens were repaired with suture tape and knotless anchors. Biomechanical analysis included displacement during cyclic loading over 250 cycles, construct stiffness, ultimate load to failure, and failure mode analysis.
  
  
  RESULTS
  Compared with transosseous repairs, quadriceps tendons repaired with knotless suture tape demonstrated significantly less displacement during cyclic loading (cycles 1-20 3.6 ± 1.3 vs 6.3 ± 1.9 mm, P = .003; cycles 20-250 2.0 ± 0.4 vs 3.1 ± 0.9 mm, P = .011), improved construct stiffness (67 ± 25 vs 26 ± 12 N/mm, P = .001), and greater ultimate load to failure (616 ± 149 vs 413 ± 107 N, P = .004). Our repair technique also demonstrated improved biomechanical parameters compared with fully threaded suture anchor repair in initial displacement during cyclic loading (cycles 1-20 3.0 ± 0.8 vs 5.1 ± 0.9 mm, P < .001), construct stiffness (62 ± 20 vs 28 ± 10 N/mm, P = .001) and ultimate load to failure (579 ± 129 vs 399 ± 87 N, P = .006).
  
  
  CONCLUSIONS
  Repair of quadriceps tendon ruptures with this knotless suture anchor with suture tape repair technique is biomechanically superior in cyclic displacement, construct stiffness, and ultimate load to failure compared with transosseous and fully threaded suture anchor techniques in cadaveric specimens.
  
  
  CONCLUSIONS
  The demonstration that our repair technique is biomechanically superior to previously described techniques in a cadaveric setting suggests that consideration should be given to this technique.
authors: Department of Orthopaedic Surgery, SUNY Stony Brook University Medical Center, Stony Brook, New York, U.S.A.
authors: Michael C
authors: MC
authors: Kindya
authors: Arthrex, Naples, Florida, U.S.A.
authors: John
authors: J
authors: Konicek
authors: Department of Orthopaedic Surgery, SUNY Stony Brook University Medical Center, Stony Brook, New York, U.S.A.
authors: Angelo
authors: A
authors: Rizzi
authors: Department of Orthopaedic Surgery, SUNY Stony Brook University Medical Center, Stony Brook, New York, U.S.A.
authors: David E
authors: DE
authors: Komatsu
authors: Department of Orthopaedic Surgery, SUNY Stony Brook University Medical Center, Stony Brook, New York, U.S.A.. Electronic address: james_paci@yahoo.com.
authors: James M
authors: JM
authors: Paci
mesh_terms: D001696:Biomechanical Phenomena; D002102:Cadaver; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D052097:Quadriceps Muscle / Q000293:injuries* / Q000601:surgery; D019651:Plastic Surgery Procedures; D053441:Suture Anchors; D013536:Suture Techniques; D013708:Tendon Injuries / Q000601:surgery*