To explore the performance of headless screws with FiberWire Suture as a tension band and headless screws with a mini-cable tension band in patella fixation. A transverse osteotomy was created in six matched pairs of fresh-frozen cadaver knee joints. One knee was randomly assigned to receive fixation with headless screws plus a cable tension band (Synthes 1.3 mm cable with crimp), while the other was fixed with headless screws plus a suture tension band (#5 FiberWire). Using a servo-hydraulic material testing system, the specimens were first tested non-destructively under 20% of the reported mean failure load with standard technique of cannulated screws with tension band wiring. The specimen was then loaded to 1000 N to test the construct's failure strength. All tests were run under displacement-control with loading threshold. A motion analysis system was used to track the interfragmentary motion to assess fixation stability. The correlation between fixation strength and score of bone density was also examined. In the non-destructive loading test, gap displacement under 150N was 0.10 mm or less for 11 of 12 specimens, and the difference between the two groups was not statistically significant. In the destructive test, 3 of 12 specimens maintained reduction (gap<2mm) at the maximum load of 1000 N. Of the failed specimens, the mean strength was 648±185 N for suture and 784±228 N for cable (p=0.24). Regression analysis shows bone density was associated with the failure load of the tendon (R2=0.43, p=0.02). There was no significant difference in fixation strength or sub-failure fragment displacement between the suture and cable tension band techniques when using headless screws, but suture on average was weaker.