🔍 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.
Simini Surgery Review Podcast
🔍 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.
Simini Surgery Review Podcast
Know What Matters in the Literature - and Why
We distill peer-reviewed surgical studies into clinically relevant summaries and
exam-style questions, so you can make informed decisions with confidence.
Free Access. No Spam. Just Smarter Surgical Learning
Multiple Choice Questions on this study
No items found.
Access the full library of surgical summaries and exam-style questions.

