No Difference in Pullout Strength Between a Bio-inductive Implant and a Semitendinosus Tendon Graft in a Biomechanical Study of Medial Patellofemoral Ligament Repair Augmentation.

To compare the pullout strength of a bio-inductive implant (BI) used to augment a medial patellofemoral ligament (MPFL) repair with the pullout strength of semitendinosus graft in a biomechanical cadaveric model. Six matched pairs of cadavers (12 knees) were used in the biomechanical testing comparing semitendinosus tendon (Semi-T) versus a BI. The Semi-T was harvested from 1 of the matched pairs. A standard double-bundle technique using 2 sockets in the upper two-thirds of the patella 15 mm apart was performed. After docking of the graft into the patella, the patella was dissected free of soft tissues and potted into a fixture to allow mechanical pull parallel to the transverse axis of the patella. The construct was pulled to failure. There was no statistically significant difference in pullout strength ( In this biomechanical study, augmentation of an MPFL reconstruction using a common double-bundle technique with a BI had the same pullout strength as a semitendinosus graft using the same technique in cadaveric knees. MPFL repair after a patellar dislocation may be inadequate to restore the strength of the native MPFL and prevent recurrent patellar instability. Recurrent instability of the patella can result in progressive injury to the soft tissue and articular cartilage of the patella and femur. It is important to study the techniques used for MPFL repair to continually improve patient outcomes. Further testing of these additional techniques and clinical studies are needed to evaluate the implants used to augment MPFL repairs.

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Déclaration de conflit d'intérêts

The authors report the following potential conflicts of interest or sources of funding: S.M. receives personal fees from Biorez, 10.13039/100019400ConMed, Mitek, BD, Trice Medical, and Micah, outside the submitted work; owns stock in Biorez, Trice Medical, Avalon AI, and Kaliber Technologies, outside the submitted work; and is on the board of directors of American Osteopathic Academy of Orthopedics and New Jersey State Orthopedic Society. M.W. receives grant support for cadaveric specimens from Biorez and Philadelphia College of Osteopathic Medicine; is on the editorial board of Journal of Arthroscopy; is a member of AANA Developmental and Membership Committee; and is AANA representative to 10.13039/100009885American Academy of Orthopaedic Surgeons Board of Specialty Societies. All other authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this work. Full ICMJE author disclosure forms are available for this article online, as supplementary material.