Suture anchor repair yields better biomechanical properties than transosseous sutures in ruptured quadriceps tendons

Verfasser / Beitragende:
[M. Petri, A. Dratzidis, S. Brand, T. Calliess, C. Hurschler, C. Krettek, M. Jagodzinski, M. Ettinger]
Ort, Verlag, Jahr:
2015
Enthalten in:
Knee Surgery, Sports Traumatology, Arthroscopy, 23/4(2015-04-01), 1039-1045
Format:
Artikel (online)
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024 7 0 |a 10.1007/s00167-014-2854-3  |2 doi 
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245 0 0 |a Suture anchor repair yields better biomechanical properties than transosseous sutures in ruptured quadriceps tendons  |h [Elektronische Daten]  |c [M. Petri, A. Dratzidis, S. Brand, T. Calliess, C. Hurschler, C. Krettek, M. Jagodzinski, M. Ettinger] 
520 3 |a Purpose: This human cadaveric study compares the biomechanical properties of quadriceps tendon repair with suture anchors and the commonly applied transosseous sutures. The hypothesis was that suture anchors provide at least equal results concerning gap formation and ultimate failure load compared with transosseous suture repair. Methods: Thirty human cadaveric knees underwent tenotomy followed by repair with either 5.5-mm-double-loaded suture anchors [titanium (TA) vs. resorbable hydroxyapatite (HA)] or transpatellar suture tunnels using No. 2 Ultrabraid™ and the Krackow whipstitch. Biomechanical analysis included pretensioning the constructs with 20N for 30s and then cyclic loading of 250 cycles between 20 and 100N at 1Hz in a servohydraulic testing machine with measurement of elongation. Ultimate failure load analysis and failure mode analysis were performed subsequently. Results: Tendon repairs with suture anchors yielded significantly less gap formation during cyclic loading (20th-250th cycle: TA 1.9±0.1, HA 1.5±0.5, TS 33.3±1.9mm, p<0.05) and resisted significantly higher ultimate failure loads (TA 740±204N, HA 572±67N, TS 338±60N, p<0.05) compared with transosseous sutures. Common failure mode was pull-out of the eyelet within the suture anchor in the HA group and rupture of the suture in the TA and TS group. Conclusion: Quadriceps tendon repair with suture anchors yields significantly better biomechanical results than the commonly applied transosseous sutures in this human cadaveric study. These biomechanical findings may change the future clinical treatment for quadriceps tendon ruptures. Randomised controlled clinical trials are desirable for the future. Level of evidence: Not applicable, controlled laboratory human cadaveric study. 
540 |a Springer-Verlag Berlin Heidelberg, 2014 
690 7 |a Quadriceps tendon repair  |2 nationallicence 
690 7 |a Suture anchors  |2 nationallicence 
690 7 |a Transpatellar tunnels  |2 nationallicence 
690 7 |a Transosseous sutures  |2 nationallicence 
690 7 |a Biomechanics  |2 nationallicence 
700 1 |a Petri  |D M.  |u Trauma Department, Hannover Medical School (MHH), Carl-Neuberg-Straße 1, 30625, Hannover, Germany  |4 aut 
700 1 |a Dratzidis  |D A.  |u Trauma Department, Hannover Medical School (MHH), Carl-Neuberg-Straße 1, 30625, Hannover, Germany  |4 aut 
700 1 |a Brand  |D S.  |u Trauma Department, Hannover Medical School (MHH), Carl-Neuberg-Straße 1, 30625, Hannover, Germany  |4 aut 
700 1 |a Calliess  |D T.  |u Orthopaedic Surgery Department, Hannover Medical School (MHH), Anna-von-Borries-Str. 1-7, 30625, Hannover, Germany  |4 aut 
700 1 |a Hurschler  |D C.  |u Laboratory for Biomaterials and Biomechanics (LBB), Orthopaedic Surgery Department, Hannover Medical School (MHH), Anna-von-Borries-Str. 1-7, 30625, Hannover, Germany  |4 aut 
700 1 |a Krettek  |D C.  |u Trauma Department, Hannover Medical School (MHH), Carl-Neuberg-Straße 1, 30625, Hannover, Germany  |4 aut 
700 1 |a Jagodzinski  |D M.  |u Trauma Department, Hannover Medical School (MHH), Carl-Neuberg-Straße 1, 30625, Hannover, Germany  |4 aut 
700 1 |a Ettinger  |D M.  |u Orthopaedic Surgery Department, Hannover Medical School (MHH), Anna-von-Borries-Str. 1-7, 30625, Hannover, Germany  |4 aut 
773 0 |t Knee Surgery, Sports Traumatology, Arthroscopy  |d Springer Berlin Heidelberg  |g 23/4(2015-04-01), 1039-1045  |x 0942-2056  |q 23:4<1039  |1 2015  |2 23  |o 167 
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950 |B NATIONALLICENCE  |P 700  |E 1-  |a Petri  |D M.  |u Trauma Department, Hannover Medical School (MHH), Carl-Neuberg-Straße 1, 30625, Hannover, Germany  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Dratzidis  |D A.  |u Trauma Department, Hannover Medical School (MHH), Carl-Neuberg-Straße 1, 30625, Hannover, Germany  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Brand  |D S.  |u Trauma Department, Hannover Medical School (MHH), Carl-Neuberg-Straße 1, 30625, Hannover, Germany  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Calliess  |D T.  |u Orthopaedic Surgery Department, Hannover Medical School (MHH), Anna-von-Borries-Str. 1-7, 30625, Hannover, Germany  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Hurschler  |D C.  |u Laboratory for Biomaterials and Biomechanics (LBB), Orthopaedic Surgery Department, Hannover Medical School (MHH), Anna-von-Borries-Str. 1-7, 30625, Hannover, Germany  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Krettek  |D C.  |u Trauma Department, Hannover Medical School (MHH), Carl-Neuberg-Straße 1, 30625, Hannover, Germany  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Jagodzinski  |D M.  |u Trauma Department, Hannover Medical School (MHH), Carl-Neuberg-Straße 1, 30625, Hannover, Germany  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Ettinger  |D M.  |u Orthopaedic Surgery Department, Hannover Medical School (MHH), Anna-von-Borries-Str. 1-7, 30625, Hannover, Germany  |4 aut 
950 |B NATIONALLICENCE  |P 773  |E 0-  |t Knee Surgery, Sports Traumatology, Arthroscopy  |d Springer Berlin Heidelberg  |g 23/4(2015-04-01), 1039-1045  |x 0942-2056  |q 23:4<1039  |1 2015  |2 23  |o 167