ArticleOrthopaedic journal of sports medicine2025
Anchor Repair of Biceps Femoris Repair Is Similar to Knotless Tunnel Repair in Laboratory Conditions.
Article in Orthopaedic journal of sports medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Avulsions of the biceps femoris and fibular collateral ligament (FCL) from the fibula often present as a knee ligament injury for treatment. Recent advances in suture anchors allow for knotless tension and retension of repair constructs in contrast to using transosseous sutures alone. The tensionable suture anchors may eliminate creep and improve the biomechanical performance of repairs at time point zero. Purpose/Hypothesis: The aim of this study is to compare the biomechanics of 2 repair constructs for biceps femoris repair. It was hypothesized that both repair constructs would effectively restore knee stability in a distal biceps femoris/FCL injury pattern, and that the modern knotless suture anchor would produce a biceps femoris repair that would fail at a higher load and exhibit greater stiffness during tensile testing. Study Design: Controlled laboratory study. Methods: Sixteen match-paired, fresh-frozen cadaveric knees (74 ± 7.5 years) were tested by external rotation (at 5 N·m) and varus (at 10 N·m) on a 6 degrees of freedom robotic system in 3 conditions: uninjured state, avulsed FCL and biceps femoris, and 1 of the 2 repair options, repair with knotless suture anchors or transosseous sutures alone. After robotic testing, repairs underwent tensile testing to failure on a uniaxial tensile testing machine to determine the failure load and stiffness of each repair construct. The mean degrees for external and varus rotation, failure load, and stiffness values were calculated for each group and compared using paired Results: Robotic testing of both repairs showed significant reductions ( Conclusion: Our study demonstrated that a transosseous biceps femoris repair with knotless suture anchors performed similarly to a transosseous biceps femoris repair with suture alone in robotic varus and external rotation testing. With tensile testing, a higher failure load was observed in each matched pair with suture anchor repair. However, no statistically significant differences were found between the restoration of knee kinematics, mean failure loads, and stiffness in these 2 repair constructs. Clinical Relevance: Understanding the biomechanical and tensile performance of the biceps femoris aids clinicians with pre- and intraoperative decisions.
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