Biomechanical evaluation of three adjunctive methods of orthopedic tension band-wire fixation to augment simulated patella tendon repairs in dogs

Abstract

Objective: To evaluate the effects of three adjunctive methods of tension band wire fixation (TBWF) on the biomechanical properties, gap formation, and failure mode in simulated canine patella tendon rupture (RPT). Study design: Randomized, ex vivo. Sample population: Paired hindlimbs from 32 dog cadavers. Methods: Patellar tendons (PTs) and associated bone-muscle-tendon units were harvested. Each PT was transected then sutured using a core locking loop and simple continuous epitendinous pattern. Each hindlimb was randomly assigned to one of three groups (n = 18 hindlimbs/group) using 18 gauge 316 L wire, anchored to the tibial crest distally, to perform transpatellar, suprapatellar, or combined tension band-wire (TBW) augmentation. Ten hindlimbs were utilized as control specimens. Yield, peak, and failure loads, stiffness, loads to 1 and 3 mm gap formation, and failure mode were evaluated. Results: Combined transpatellar and suprapatellar TBW augmentation was superior to transpatellar or suprapatellar groups alone. Yield (p =.0008), peak (p =.004), and failure loads (p =.005) were greater for the combined group than for the transpatellar (p =.048) and suprapatellar groups (p =.01) respectively. There was no difference regarding the occurrence of 1 or 3 mm gap formation (1 mm, p =.05; 3 mm, p =.06); however, loads required to cause gap formation were greater in the combined group (p =.036). Mode of failure differed between techniques used for PT augmentation (p