ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2015
Suture anchor repair yields better biomechanical properties than transosseous sutures in ruptured quadriceps tendons.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 1 of them a synthesis that pooled it.
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Who cites it
36 citing papers in PubMed, 1 synthesis or guideline pooled it, 78 citations in OpenAlex.
- Early, Bilateral Re-Rupture of Quadriceps Tendon After Previous Bone-Anchor Repair for Simultaneous, Low-Energy, Bilateral Quadriceps Rupture: A Case Report and Literature Review.The American journal of case reports · 2021Pooled it
- Trial
- Structural and Functional Principles in Quadriceps Reconstruction.Muscles (Basel, Switzerland) · 2026Review
- A modified transosseous quadriceps tendon refixation technique demonstrates advantageous primary stability: A biomechanical investigation.Journal of experimental orthopaedics · 2026Article
- The "Acuflex ACL Guide-Assisted Transosseous Tunnel" Quadriceps Tendon Repair Technique a Straightforward, Replicable, and Step-by-Step Demonstration of a Novel Technique on a Cadaveric Specimen.Indian journal of orthopaedics · 2025Article
- Patients have restored extensor mechanism function with low complication rates following quadriceps tendon repair: A systematic review.Journal of orthopaedics · 2025Review
- A Low-Cost Tensionable Quadriceps Tendon Rupture Repair Using Transosseous Tunnels.Arthroscopy techniques · 2025Article
- Article
- Quadriceps Tendon Repair Using Knotless All-Suture Anchors With Transosseous Fixation.Arthroscopy techniques · 2025Article
- Comparing clinical outcomes between transosseous patellar suture fixation versus suture anchor repair in the treatment of quadriceps tendon rupture.Journal of clinical orthopaedics and trauma · 2025Article
- Clinical Outcomes of Hip Abductor Repair Using Transosseous Sutures Versus Suture Anchors: A Systematic Review and Meta-analysis.Orthopaedic journal of sports medicine · 2025Review
- Evaluating Failure Rates of Primary Quadriceps Tendon Repairs Across Different Surgical Techniques.Orthopaedic journal of sports medicine · 2025Article
- Previous Extensor Mechanism Repair Is Associated With Increased Rates of Surgical Complications Following Total Knee Arthroplasty: A Propensity-matched Analysis.Arthroplasty today · 2024Article
- Similar Outcomes Are Found Between Quadriceps Tendon Repair With Transosseous Tunnels and Suture Anchors: A Systematic Review and Meta-Analysis.Arthroscopy, sports medicine, and rehabilitation · 2023Article
- Midterm outcome and strength assessment after quadriceps tendon refixation with suture anchors.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2023Article
- Bilateral Quadriceps Tendon Rupture in a Healthy Individual Following a Motor Vehicle Accident: A Case Report.Cureus · 2023Article
- Repair of Bilateral Quadriceps Tendon Rupture Using a Modified Knotless Suture Anchor and Internal Brace Technique: Surgical Technique and Case Report.Orthopaedic surgery · 2022Article
- Extensor mechanism ruptures.EFORT open reviews · 2022Review
- Comparison of Biomechanical Failure Loads Between Tape-Type and Conventional Sutures in Internal Knotless Anchor-Based Constructs.Orthopaedic journal of sports medicine · 2022Article
- A Survey of Treatment Trends for Acute Quadriceps Tendon Ruptures Among North American Surgeons.Orthopaedic journal of sports medicine · 2022Article
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThis 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.
methodsThirty 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 20 N for 30 s and then cyclic loading of 250 cycles between 20 and 100 N at 1 Hz in a servohydraulic testing machine with measurement of elongation. Ultimate failure load analysis and failure mode analysis were performed subsequently.
resultsTendon 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 ± 1.9 mm, p < 0.05) and resisted significantly higher ultimate failure loads (TA 740 ± 204 N, HA 572 ± 67 N, TS 338 ± 60 N, 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.
conclusionQuadriceps 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.
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