🔍 Key Findings
- Combined transpatellar and suprapatellar TBW augmentation had significantly greater yield (p = .0008), peak (p = .004), and failure loads (p = .005) than either technique alone.
- Construct stiffness was highest in the combined TBW group, indicating greater resistance to deformation.
- Gap formation >3 mm was least frequent in the combined group (6%), suggesting better tendon apposition and healing potential.
- Predominant failure mode in the combined group was wire unraveling (39%), whereas core suture pull-through was more common in transpatellar (67%) and suprapatellar (44%) groups.
- Patellar fractures occurred only in the combined group (11%), possibly due to transosseous tunnel placement.
- Combined TBW augmentation more closely approximated the strength of native intact tendons, per control comparisons.
- Despite similar rates of early gapping, load required to produce gap formation was significantly higher in the combined group (p = .036).
- All specimens used locking loop (LL) core sutures with simple continuous epitendinous suture (SCES) for primary repair, offering a standardized base for augmentation comparison.
