An Isolated Transosseous Flexible Suture Frame in the Treatment of Patellar Tendon Rupture Provides Adequate Mechanical Resistance

Pablo Besa, Alberto Telias, Francisca Orrego, Rodrigo Guzmán-Venegas, Martín Cariola, Diego Amenábar, Felipe H. Palma, Sebastián Irarrázaval*, Mario Orrego

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Introduction:Acute patellar tendon ruptures are frequently observed in patients with metabolic comorbidities, and the benchmark treatment is surgical repair. It is desirable not to harm an already fragile biologic environment with sutures and hardware. We aimed to compare the mechanical requirements of an isolated, flexible, high-strength nonabsorbable transosseous suture frame with that of the Krackow suture technique.Methods:A total of 12 cadaveric pieces were randomized into two groups: The isolated flexible frame group (n = 6) and the standard Krackow fixation group (n = 6). A traumatic rupture of the patellar tendon was performed, and a transosseous displacement sensor was installed on a validated biomechanical system. Gap formation was measured during 50 cycles of flexion and extension with traction on the quadriceps (250 N). Subsequently, specimens underwent progressive loading in a fixed flexion position until failure occurred. The data were analyzed using nonparametric statistical tools with a significance level of 5%.Results:The isolated frame group had a smaller gap formation (1.7 mm) than the Krackow group (3.4 mm; P = 0.01). No significant difference existed in the median failure end points of the two groups (676 and 530 N, respectively; P = 0.11).Discussion:Patellar tendon repair using an isolated, transosseous, flexible, suture frame outperformed using the traditional Krakow repair technique in gap formation. Further studies are needed to determine if this will result in better functional outcomes or fewer clinical failures.

Original languageEnglish
Pages (from-to)E251-E257
Number of pages7
JournalThe Journal of the American Academy of Orthopaedic Surgeons
Issue number5
StatePublished - 1 Mar 2021

Bibliographical note

Copyright © 2020 by the American Academy of Orthopaedic Surgeons.


  • Biomechanical Phenomena
  • Cadaver
  • Humans
  • Patellar Ligament/surgery
  • Rupture/surgery
  • Suture Anchors
  • Suture Techniques
  • Sutures
  • Tendon Injuries/surgery


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