scholarly journals Adjustable Cortical Fixation Device for Quadriceps Tendon Repair: A Cadaveric Biomechanical Study

2021 ◽  
Vol 9 (1) ◽  
pp. 232596712097439
Author(s):  
Heath P. Gould ◽  
William R. Rate ◽  
Pooyan Abbasi ◽  
Katherine L. Mistretta ◽  
Jason W. Hammond
Keyword(s):  
Cyclic Loading ◽  
Suture Anchor ◽  
Tendon Repair ◽  
Quadriceps Tendon ◽  
Fixation Device ◽  
Peak Displacement ◽  
Anchor Group ◽  
Fixation Group ◽  
The Mean ◽  
Suture Anchor Repair

Background: Adjustable cortical fixation devices have demonstrated utility in orthopaedic applications, such as ankle syndesmosis repair. Purpose: To assess the cyclic gap formation of a quadriceps tendon repair technique using an adjustable cortical fixation device compared with repair with knotless suture anchors and suture tape, a modification of conventional suture anchor repair. Study Design: Controlled laboratory study. Methods: Eight fresh-frozen matched pairs of cadaveric knees were used. Specimens in each pair were randomized to undergo either modified suture anchor repair (control) or adjustable cortical fixation repair. The control repair was performed as previously described. The experimental repair was performed using 2 No. 2 FiberWire sutures placed into the quadriceps tendon in a running locked Krackow configuration and 2 adjustable loop devices passed through transosseous tunnels. The lagging strands of the devices were tensioned to seat the cortical fixation buttons at the inferior patellar pole and then tied to the free Krackow strands at the superior pole to complete the repair. The mean plastic gap (permanent tendon displacement that did not recover with cyclic extension) and mean maximum gap (peak displacement that occurred with cyclic knee flexion and partially recovered with extension) were evaluated during cyclic loading for 500 cycles of full knee extension to 90° of flexion. Results: At all testing intervals, the mean plastic gap was significantly smaller for the cortical fixation group versus the suture anchor group ( P < .02). Similarly, the mean maximum gap was significantly smaller for the cortical fixation specimens at all testing intervals ( P < .01). After cyclic loading, the mean maximum gap was significantly smaller in the cortical fixation group (4.80 ± 1.56 mm) versus the suture anchor group (8.47 ± 1.47 mm; P = < .001). The mean plastic gap was also significantly smaller in the cortical fixation versus the suture anchor group (3.25 ± 1.10 mm vs 6.57 ± 1.62 mm, respectively; P = < .001). Conclusion: Quadriceps tendon repair using an adjustable cortical fixation device demonstrated superior biomechanical properties in cyclic displacement testing compared with repair using the suture anchor technique. Clinical Relevance: These results suggest that an adjustable cortical fixation device is a biomechanically viable alternative for quadriceps tendon repair.

scholarly journals Double-crossed knotless suture anchor repair of quadriceps rupture

2021 ◽  
Author(s):  
Waqas Ali ◽  
Javaid Iqbal ◽  
Liam Leonard ◽  
Paul O'Grady
Keyword(s):  
Tendon Rupture ◽  
Suture Anchor ◽  
Quadriceps Tendon ◽  
Quadriceps Tendon Rupture ◽  
Effective Treatment Option ◽  
The Mean ◽  
Suture Anchor Fixation ◽  
Anchor Fixation ◽  
Suture Anchor Repair

Abstract Quadriceps tendon rupture is an uncommon injury but may result in long term disability if not adequately repaired. Many techniques are described for repair of acute quadriceps tendon rupture, including tendon-to-tendon repair, trans-osseous tunnels, synthetic augmentation, tendon plasty and the use of suture anchors. There is no single accepted surgical treatment. This study's objective was to assess the efficacy of a double-crossed suture anchor repair in the management of quadriceps tendon rupture. Materials and methods: 85 patient attended our institute for surgical management of quadriceps tendon rupture over eight years (2012-2019). Seven patients were treated with the use of a double-crossed suture anchor fixation. These patients were allowed to weight bear in a hinged knee brace for six weeks following surgery. Six out of seven patients had one or more predisposing co-morbidities, including obesity, diabetes, renal failure, quinolone and steroid use. Results: Clinical and functional outcome were recorded during follow up visits prospectively for a mean of one year (10-14 months). The mean knee flexion was 124 degree (120 -130). All patients were able to return to activities of daily living (ADL) with a mean of 2 months (1.5-3 months) and return to work at a mean of 6 months (4-8 months). The mean Tegner, Cincinnati and Lysholm score at the latest follow up were 2.8 (0-5), 79.2 (60-88) and 90 (70-100), respectively. There were no early complications. There was no re-tear reported at the latest follow up. Conclusion : The double-crossed suture anchor fixation is a safe and effective treatment option in managing quadriceps tendon ruptures.

Biomechanical Evaluation of Suture Anchor versus Transosseous Tunnel Patellar Tendon Repair Techniques

2018 ◽  
Vol 32 (08) ◽  
pp. 825-832 ◽  
Author(s):  
Seth L. Sherman ◽  
Brandee Black ◽  
Matthew A. Mooberry ◽  
Katie L. Freeman ◽  
Trevor R. Gulbrandsen ◽  
...  
Keyword(s):  
Cyclic Loading ◽  
Failure Mode ◽  
Bone Quality ◽  
Ultimate Load ◽  
Suture Anchor ◽  
Tendon Repair ◽  
Tensile Load ◽  
Significant Difference ◽  
Load To Failure ◽  
Suture Anchor Repair

AbstractThe objective of this study is to compare the cyclic loading strength and ultimate failure load in suture anchor repair versus transosseous tunnel repair of patellar tendons using a cadaver model. Twelve cadaveric patella specimens were used (six matched pairs). Dual-energy X-ray absorptiometry (DXA) measurements were performed to ensure equal bone quality among groups. All right knees were assigned to the suture anchor repair group (n = 6), whereas all left knees were assigned to the transosseous bone tunnel group (n = 6). Suture type and repair configuration were equivalent. After the respective procedures were performed, each patella was mounted into a gripping jig. Tensile load was applied at a rate of 1 Hz between magnitudes of 50 and 150 N, 50 and 200 N, 50 and 250 N, and tensile load at a rate of 0.1 mm/s until failure. Failure was defined as a sharp deviation in the linear load versus displacement curve, and failure mode was recorded. DXA measurements demonstrated equivalence of bone quality between the two groups (p > 0.05). During cyclic load testing, there was only a statistically significant difference between the groups with regard to cyclic loading at the 50 to 200 N loading cycle (p = 0.010). There was no statistically significant difference between the groups with regard to ultimate load to failure (p = 0.43). Failure mode within the suture anchor cohort occurred through anchor pullout except for one, which failed through the tendon. All specimens within the transosseous cohort failed through the midsubstance of the tendon except for one, which failed through suture breakage. Suture anchor repair demonstrated a similar biomechanical profile regarding cyclic loading and ultimate load to failure when compared with “gold standard” transosseous tunnel patellar tendon repair with a trend toward less gapping in the suture anchor group. Using suture anchors for repair of the patella tendon has similar biomechanical properties to transpatellar tunnels but may provide other clinical advantages.

Biomechanical Evaluation of Suture Anchor Versus Transosseous Tunnel Quadriceps Tendon Repair Techniques

2016 ◽  
Vol 32 (6) ◽  
pp. 1117-1124 ◽  
Author(s):  
Seth L. Sherman ◽  
Marilyn E. Copeland ◽  
Jeffrey L. Milles ◽  
David A. Flood ◽  
Ferris M. Pfeiffer
Keyword(s):  
Suture Anchor ◽  
Tendon Repair ◽  
Quadriceps Tendon ◽  
Biomechanical Evaluation ◽  
Repair Techniques

scholarly journals Arthroscopic Quadriceps Tendon Repair: Two Case Reports

2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Hidetomo Saito ◽  
Yoichi Shimada ◽  
Toshiaki Yamamura ◽  
Shin Yamada ◽  
Takahiro Sato ◽  
...  
Keyword(s):  
Suture Anchor ◽  
Case Reports ◽  
Tendon Repair ◽  
Quadriceps Tendon ◽  
Tendon Injury ◽  
Arthroscopic Repair ◽  
Pull Out ◽  
One Year ◽  
Bone Tunnels ◽  
Pull Out Suture

Recently, although some studies of open repair of the tendon of the quadriceps femoris have been published, there have been no reports in the literature on primary arthroscopic repair. In our present study, we present two cases of quadriceps tendon injury arthroscopically repaired with excellent results. Case 1 involved a 68-year-old man who was injured while shifting his weight to prevent a fall. MRI showed complete rupture at the insertion of the patella of the quadriceps tendon. The rupture was arthroscopically repaired using both suture anchor and pull-out suture fixation methods via bone tunnels (hereafter, pull-out fixation). Two years after surgery, retearing was not observed on MRI and both Japan Orthopedic Association (JOA) Knee and Lysholm scores had recovered to 100. Case 2 involved a 50-year-old man who was also injured when shifting his weight to prevent a fall. MRI showed incomplete superficial rupture at the insertion of the patella of the quadriceps tendon. The rupture was arthroscopically repaired using pull-out fixation of six strand sutures. One year after surgery, MRI revealed a healed tendon and his JOA and Lysholm scores were 95 and 100, respectively. Thus, arthroscopic repair may be a useful surgical method for repairing quadriceps tendon injury.

Suture Anchor Repair of Quadriceps Tendon Rupture

Orthopedics ◽  
2014 ◽  
Vol 37 (3) ◽  
pp. 183-186 ◽  
Author(s):  
Joshua D. Harris ◽  
Geoffrey D. Abrams ◽  
Adam B. Yanke ◽  
Michael D. Hellman ◽  
Brandon J. Erickson ◽  
...  
Keyword(s):  
Tendon Rupture ◽  
Suture Anchor ◽  
Quadriceps Tendon ◽  
Quadriceps Tendon Rupture ◽  
Suture Anchor Repair

Suture Anchor Repair of Quadriceps Tendon and Patellar Tendon Ruptures

2019 ◽  
Vol 34 (2) ◽  
pp. 134-139
Author(s):  
Joel Huleatt ◽  
Aaron Gebrelul ◽  
Ajay Premkumar ◽  
John Xerogeanes
Keyword(s):  
Patellar Tendon ◽  
Suture Anchor ◽  
Quadriceps Tendon ◽  
Tendon Ruptures ◽  
Suture Anchor Repair

scholarly journals Biomechanical Comparison of Flexor Digitorum Profundus Avulsion Repair

2019 ◽  
Vol 08 (04) ◽  
pp. 312-316 ◽  
Author(s):  
Jill G. Putnam ◽  
Damon Adamany
Keyword(s):  
Suture Anchor ◽  
Tendon Repair ◽  
Maximum Load ◽  
Flexor Digitorum Profundus ◽  
Anchor Group ◽  
Load To Failure ◽  
Group 3 ◽  
Group 2 ◽  
Flexor Digitorum ◽  
Group 1

Purpose Multiple repair techniques have been investigated for flexor digitorum profundus (FDP) tendon avulsions. The purpose of this study is to compare the biomechanical characteristics of a new fully threaded titanium suture anchor with previously examined fixation techniques. Methods Repair of FDP tendon avulsions was performed in 18 fresh-frozen cadavers using one of three implants: Nano Corkscrew FT 1.7 mm suture anchor (Group 1; Arthrex, Inc., Naples, FL; n = 6), Mitek Micro 1.3 mm suture anchor (Group 2; Mitek Surgical Products, Westwood, MA; n = 6), or pullout suture button fixation (Group 3; n = 6). Constructs were preloaded before testing load to failure. For each trial, elongation at 20 N and maximum load, mean load to failure, stiffness, and failure mechanism were recorded. Results Load to failure occurred in all trials. Mean load to failure was significantly greater for Group 1 (61.6 ± 18.9 N) compared to Group 2 (42.5 ± 4.2 N; p < 0.05) and Group 3 (41.6 N ± 8.0 N; p < 0.05). Stiffness was significantly greater in Groups 1 and 2 compared to Group 3 (6.9 ± 2.2 N/mm vs. 6.1 ± 0.8 N/mm vs. 3.1 N/mm ± 0.5 N/mm, respectively, p < 0.01). Mechanism of failure differed between the groups: Group 1 broke at the anchor in two trials and tore through the tendon in three trials, Group 2's suture universally broke at the anchor, and Group 3's trials mainly failed at the button. Conclusions The Nano Corkscrew anchor (Group 1) has a significantly higher load to failure when compared with the other techniques. The higher load to failure of the corkscrew anchor provides a secure method for flexor tendon repair in zone I. Clinical Relevance A fully threaded titanium suture anchor used for FDP tendon avulsion injuries is likely to withstand early active range of motion protocols.

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