Biomechanical analysis of the cruciate four-strand flexor tendon repair

McLarney, Elizabeth A.; Hoffman, Hans; Wolfe, Scott W.

doi:10.1053/jhsu.1999.0295

Cited by 157 publications

(143 citation statements)

References 32 publications

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“…Therefore we compared the forces needed to cheese-wire a uniform suture loop through human, pig and sheep deep flexor tendons. A 2 mm bite was chosen because this depth reflects a typical locking loop bite into the tendon substance used in most suture configurations, such as Kessler, 30) Tsuge, 31) Cruciate, 7) Cross Locked Cruciate (Adelaide) 16) or Tang 10) repair. A 2 mm bite is also the recommended minimum depth for any circumferential repair.…”

Section: Resultsmentioning

confidence: 99%

Animal Models for Tendon Repair Experiments: A Comparison of Pig, Sheep and Human Deep Flexor Tendons in Zone II

Peltz

Hoffman

Scougall

et al. 2017

J Hand Surg Asian-Pac Vol

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Background: This laboratory study compared pig, sheep and human deep flexor tendons in regards to their biomechanical comparability. Methods: To investigate the relevant biomechanical properties for tendon repair experiments, the tendons resistance to cheese-wiring (suture drag/splitting) was assessed. Cheese-wiring of a suture through a tendon is an essential factor for repair gapping and failure in a tendon repair. Results: Biomechanical testing showed that forces required to pulling a uniform suture loop through sheep or pig tendons in Zone II were higher than in human tendons. At time point zero of testing these differences did not reach statistical significance, but differences became more pronounced when forces were measured beyond initial cheese-wiring (2 mm, 5 mm and 10 mm). The stronger resistance to cheese-wiring was more pronounced in the pig tendons. Also regarding size and histology, sheep tendons were more comparable to human tendons than pig tendons. Conclusions: Differences in tendon bio-properties should be kept in mind when comparing and interpreting the results of laboratory tendon experiments.

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Section: Resultsmentioning

confidence: 99%

Animal Models for Tendon Repair Experiments: A Comparison of Pig, Sheep and Human Deep Flexor Tendons in Zone II

Peltz

Hoffman

Scougall

et al. 2017

J Hand Surg Asian-Pac Vol

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“…Not only are there fewer needle passes, but the authors found the DGL-IHM technique relatively easy to perform with little change in the shape of the tendon [3,37,39,53]. As these six crossing sutures are not individual strands, they are likely to have different biomechanical properties than a traditional six-strand repair.…”

Section: Discussionmentioning

confidence: 99%

“…It is suggested that the Adelaide repair technique (CLC), first reported by Sandow and McMahon [46], is more favorable than other selected four-strand techniques in terms of strength, gap formation, and simplicity [2,4,6,11,39]. FiberWire was chosen because it has been shown to provide greater strength than similar low-profile braided sutures [36,41].…”

Section: Introductionmentioning

confidence: 99%

Biomechanical Comparison of Double Grasping Repair versus Cross-Locked Cruciate Flexor Tendon Repair

Dwyer

Dominy

Cooney

et al. 2014

Hand (New York, N,Y.)

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Purpose This study was conducted to compare the in vitro biomechanical properties of tensile strength and gap resistance of a double grasping loop (DGL) flexor tendon repair with the established four-strand cross-locked cruciate (CLC) flexor tendon repair, both with an interlocking horizontal mattress (IHM) epitendinous suture. The hypothesis is that the DGL-IHM method which utilizes two looped core sutures, grasping and locking loops, and a single intralesional knot will have greater strength and increased gap resistance than the CLC-IHM method. Methods Forty porcine tendons were evenly assigned to either the DGL-IHM or CLC-IHM group. The tendon repair strength, 2-mm gap force and load to failure, was measured under a constant rate of distraction. The stiffness of tendon repair was calculated and the method of repair failure was analyzed. Results The CLC-IHM group exhibited a statistically significant greater resistance to gapping, a statistically significant higher load to 2-mm gapping (62.0 N), and load to failure (99.7 N) than the DGL-IHM group (37.1 N and 75.1 N, respectively). Ninety percent of CLC-IHM failures were a result of knot failure whereas 30 % of the DGL-IHM group exhibited knot failure.Conclusions This study demonstrates that the CLC-IHM flexor tendon repair method better resists gapping and has a greater tensile strength compared to the experimental DGL-IHM method. The authors believe that while the DGL-IHM provides double the number of sutures at the repair site per needle pass, this configuration does not adequately secure the loop suture to the tendon, resulting in a high percentage of suture pullout and inability to tolerate loads as high as those of the CLC-IHM group.

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“…The present paper was based on an experimental study on rabbits. In the literature, there are studies with a variety of investigation protocols in which models were applied to cadavers and to animals such as pigs, dogs and rabbits, using different suture materials (nylon, mersilene, Ethibond, Dacron and steel) (14)(15)(16)(17)(18)(19)(20)(21)(22) . Despite the diversity of experimental investigation on animals, the greatest quantity of research has been on cadavers.…”

Section: Biomechanics and Histological Analysis In Rabbit Flexor Tendmentioning

confidence: 99%

Análise biomecânica e histológica de tendões flexores reparados em coelhos usando três técnicas de sutura (quatro e seis passadas) com mobilização ativa precoce

Severo¹,

Arenhart²,

Silveira³

et al. 2012

Rev. bras. ortop.

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0,01). Não houve diferença estatística com relação ao tempo cirúrgico na realização das três técnicas de suturas (p > 0,01). Evidenciou-se, qualitativamente e quantitativamente, com a mobilidade ativa precoce, um espessamento da fibra de colágeno em 38,9% dentro do 15º dia e de 66,7% dentro do período do 30º dia (p = 0,095). CONCLUSÃO: Esta investigação serviu para demonstrar que não houve diferença histológica do nó final da sutura central dentro ou fora do tendão reparado, bem como o número de passadas, no que diz respeito à cicatrização, vascularização ou deformidade do tendão no túnel osteofibroso com as técnicas de reparo aplicadas, associados de mobilização ativa precoce.]]>

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Biomechanical analysis of the cruciate four-strand flexor tendon repair

Cited by 157 publications

References 32 publications

Animal Models for Tendon Repair Experiments: A Comparison of Pig, Sheep and Human Deep Flexor Tendons in Zone II

Animal Models for Tendon Repair Experiments: A Comparison of Pig, Sheep and Human Deep Flexor Tendons in Zone II

Biomechanical Comparison of Double Grasping Repair versus Cross-Locked Cruciate Flexor Tendon Repair

Análise biomecânica e histológica de tendões flexores reparados em coelhos usando três técnicas de sutura (quatro e seis passadas) com mobilização ativa precoce

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