🔍 Key Findings
- Combined transpatellar + suprapatellar TBW technique yielded higher yield, peak, and failure loads than either technique alone.
- Construct stiffness was significantly higher in the combined group (61.2 N/mm) vs transpatellar (46.8 N/mm) and suprapatellar (28.5 N/mm).
- Lower incidence of gap formation in the combined group: only 22% had 1 mm gap vs 61% (transpatellar) and 39% (suprapatellar).
- Load to 3 mm gap was significantly higher in the combined group (p = .036), suggesting superior early repair site stability.
- Failure modes varied: suprapatellar most often failed via wire unraveling (67%), transpatellar via suture pull-through (67%); combined group had lower incidence of both.
- Patella fractures were observed only in the combined group (11%), likely due to transosseous tunnel stress.
- Wire unraveling was a predominant failure mode in suprapatellar (67%) and combined (39%) groups, but core suture pull-through was more common in the transpatellar group (67%); failure occurred by unraveling, not cyclic breakage.
- Study supports TBW augmentation to reduce load on primary repair and improve biomechanical durability of patellar tendon repairs.
