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J Knee Surg 2023; 36(12): 1224-1229
DOI: 10.1055/s-0042-1755374
Original Article

Effect of Poly-L-Lactic Acid Mesh Augmentation on Cyclic Gap Formation in Transosseous Patellar Tendon Repair: A Biomechanical Study

Heath P. Gould
1   Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, Maryland
,
William R. Rate IV
2   Georgetown University School of Medicine, Washington, District of Columbia
,
Ryan A. Harrell
1   Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, Maryland
,
Pooyan Abbasi
1   Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, Maryland
,
Allison L. Fillar 
1   Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, Maryland
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Abstract

No previous study has investigated poly-L-lactic acid (PLLA) surgical mesh augmentation in the repair of inferior pole patellar tendon rupture. We compared the biomechanical properties of transosseous patellar tendon repair with PLLA surgical mesh augmentation to transosseous repair without augmentation. Ten matched pairs of cadaveric knees were used. Specimens in each pair were randomized to undergo the transosseous technique alone or the transosseous technique augmented with a PLLA surgical mesh. An inferior pole patellar tendon rupture was simulated and the repair procedure was performed. Specimens were cyclically loaded for 500 cycles. Gap formation was measured using two sensors placed medial and lateral to the repair site. After cyclic loading, load to failure was determined by pulling the tendon at a constant rate until a sudden decrease in load occurred. The primary outcome measure was cyclic gap formation at the medial and lateral sensors. Compared with controls, specimens that underwent PLLA mesh-augmented repair had significantly lower medial gap formation at all testing intervals up to 500 cycles (p < 0.05) and significantly lower lateral gap formation at all testing intervals from 10 to 500 cycles (p < 0.05). Transosseous patellar tendon repair augmented with a PLLA woven mesh device provided significantly greater resistance to gap formation compared with transosseous repair alone. These results suggest that PLLA mesh augmentation of the transosseous technique is biomechanically effective for patellar tendon repair.

Keywords

patellar - tendon - poly-L-lactic acid - mesh - cadaveric - biomechanics

Note

Synthasome, Inc. donated hardware for this study; Arthrex, Inc. donated hardware for this study; all authors have no disclosures to report.




Publication History

Received: 22 June 2021

Accepted: 19 June 2022

Article published online:
01 September 2022

© 2022. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

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