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The Semi\u2010T was harvested from 1 of the matched pairs. A standard double\u2010bundle technique using 2 sockets in the upper two\u2010thirds 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      There was no statistically significant difference in pullout strength (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .77) between the BI group (249.3 \u00b1 36.3 N) and Semi\u2010T group (235.0\n                      <jats:bold>\u00b1<\/jats:bold>\n                      113.6 N) double\u2010bundle constructs. In the Semi\u2010T group, 50% of the specimens (3 of 6 knees) failed via anchor pullout and a fourth specimen failed at the suture\u2010anchor interface (16.7%), whereas in the BI group, 16.7% of the specimens (1 of 6 knees) failed by anchor pullout. Although the Semi\u2010T group (49.5 \u00b1 14.1 N\/mm) showed significantly greater stiffness than the BI group (13.8 \u00b1 0.6 N\/mm,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .01), pullout strength in the Semi\u2010T group was highly variable: 50% of the specimens (3 of 6 knees) with semitendinosus constructs failed at 5 mm of displacement or less via graft or anchor pullout. Maximum load, displacement at failure, stiffness, and load at 5 mm were compared between the augmented and non\u2010augmented control specimens using a 2\u2010tailed non\u2010equal variance Student\n                      <jats:italic>t<\/jats:italic>\n                      test. For all comparisons,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .05 was considered to indicate a statistically significant difference.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this biomechanical study, augmentation of an MPFL reconstruction using a common double\u2010bundle technique with a BI had the same pullout strength as a semitendinosus graft using the same technique in cadaveric knees.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.asmr.2023.100827","type":"journal-article","created":{"date-parts":[[2024,1,23]],"date-time":"2024-01-23T14:28:50Z","timestamp":1706020130000},"update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":8,"title":["No Difference in Pullout Strength Between a Bio\u2010inductive Implant and a Semitendinosus Tendon Graft in a Biomechanical Study of Medial Patellofemoral Ligament Repair Augmentation"],"prefix":"10.1002","volume":"6","author":[{"given":"Austin","family":"Wetzler","sequence":"first","affiliation":[{"name":"Lewis Katz School of Medicine Temple University Philadelphia Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sean","family":"McMillan","sequence":"additional","affiliation":[{"name":"Virtua College of Medicine and Life Sciences Rowan University Strafford New Jersey U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erik","family":"Brewer","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering Rowan University Glassboro New Jersey U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aakash","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Philadelphia College of Osteopathic Medicine Philadelphia Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel","family":"Handy","sequence":"additional","affiliation":[{"name":"Lewis Katz School of Medicine Temple University Philadelphia Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Merrick","family":"Wetzler","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Philadelphia College of Osteopathic Medicine Philadelphia Pennsylvania U.S.A."},{"name":"Virtua Health Voorhees New Jersey U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,1,23]]},"reference":[{"key":"e_1_2_3_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/03635465211013543"},{"key":"e_1_2_3_3_2","doi-asserted-by":"publisher","DOI":"10.5792\/ksrr.2015.27.3.133"},{"key":"e_1_2_3_4_2","volume-title":"StatPearls. 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Published by Elsevier Inc. on behalf of the Arthroscopy Association of North America.","name":"copyright","label":"Copyright"}],"article-number":"100827"}}