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  • Title: Biomechanical comparison of a novel tensioned cable construct versus tension band wiring for transverse patella fracture fixation.
    Author: Kagan BD, Sundet AD, Gardner-Morse M, Chaidarun PL, Beynnon BD, Schottel PC.
    Journal: Eur J Orthop Surg Traumatol; 2023 Jul; 33(5):1573-1580. PubMed ID: 35759107.
    Abstract:
    PURPOSE: Tension band wiring (TBW) is the most widely accepted method for patella fracture fixation. The purpose of our study was to compare the biomechanical efficacy of a novel cable construct to TBW for the fixation of transverse patella fractures. The tensioned cable construct was hypothesized to have less fracture gapping after cyclic flexion-extension loading and greater ultimate load to failure as compared to TBW. METHODS: Transverse patellar osteotomies (AO/OTA 34C1.1) were performed on nine pairs of fresh-frozen human cadaveric whole legs (mean age 82.2 years, range 71-101). Treatment with TBW or tensioned cable construct was randomized within each specimen pair. Fracture site displacement was measured after 5000 flexion-extension cycles from 0° to 90° at 0.5 Hz. In load to failure testing, the knee was fixed at 45° of flexion and the quadriceps tendon was pulled proximally at 0.5 mm/sec until patella fixation failure. Comparisons were made using paired t-tests with alpha values of 0.05. RESULTS: Eight paired specimens completed the cyclic loading. The tensioned cable construct had significantly less fracture gapping than TBW (2.9 vs 10.9 mm; p = 0.020). Seven paired limbs underwent load to failure testing, which revealed no significant difference between the tensioned cable construct and TBW (1551.6 N vs 1664.0 N; p = 0.26). CONCLUSION: In this study of transverse patella fracture fixation, a tensioned cable construct demonstrated significantly less fracture gapping compared to TBW in response to cyclic loading with no significant difference in load at failure.
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