Introduction

No prior 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 Krackow transosseous patellar tendon repair with PLLA surgical mesh augmentation to Krackow transosseous repair without augmentation.

Methods

Ten matched pairs of cadaveric knees were used. Specimens in each pair were randomized to undergo the Krackow 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. Cyclic gap formation at the medial and lateral sensors was averaged to calculate mean gap.

Results

Compared to controls, specimens that underwent PLLA mesh-augmented repair had significantly lower mean gap formation at 20 cycles (p=0.04), 50 cycles (p=0.02), 100 cycles (p=0.01), 200 cycles (p=0.02), and 500 cycles (p=0.01).

Conclusions

Krackow transosseous patellar tendon repair augmented with a PLLA woven mesh device provided significantly greater resistance to gap formation compared to Krackow transosseous repair alone. These results suggest that PLLA mesh augmentation of the Krackow transosseous technique is biomechanically effective for patellar tendon repair.