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Biomechanical and Clinical Evaluation of a Modified 3‐Loop Pulley Suture Pattern for Reattachment of Canine Tendons to Bone
Author(s) -
Moores Andy P.,
Comerford Eithne J.,
Tarlton John F.,
Owen Martin R.
Publication year - 2004
Publication title -
veterinary surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.652
H-Index - 79
eISSN - 1532-950X
pISSN - 0161-3499
DOI - 10.1111/j.1532-950x.2004.04057.x
Subject(s) - pulley , medicine , cadaver , fibrous joint , tendon , biomechanics , avulsion , loop (graph theory) , anatomy , orthodontics , biomedical engineering , structural engineering , combinatorics , engineering , mathematics
Objective— To describe a modified 3‐loop pulley suture pattern for the reattachment of canine tendons to bone along with a biomechanical comparison with the locking‐loop suture. Study Design— In vitro biomechanical study and clinical case report. Animals or Sample Population— Biomechanical study: 10 paired gastrocnemius tendons and calcaneii harvested from 5 canine cadavers. Case report: a Doberman with avulsion of the gastrocnemius tendon of insertion. Methods— Biomechanical study: paired tendons were reattached to the calcaneus with either a modified 3‐loop pulley pattern or a locking‐loop pattern. Tensile loading to failure was performed. A direct, non‐contact, method of gap measurement, using digital video, was used to measure gap formation. Load required to initiate gap formation (defined as load at a 1 mm gap) and to produce a 3 mm gap was evaluated in addition to maximum load and gap at failure. Results— Mean (±SEM) 1 mm gap loads were 31.0±4.2 and 17.2±2.5 N, mean 3 mm gap loads were 49.1±2.4 and 28.9±3.2 N, and mean maximum loads were 72.9±4.3 and 55.8±2.2 N for the modified 3‐loop pulley suture and the locking‐loop suture, respectively. These differences were statistically significant ( P <.05). The gap at failure was similar for both repairs. The clinical case remained sound 7 months postoperatively. Conclusions— A modified 3‐loop pulley pattern is biomechanically superior to a locking‐loop pattern for reattachment of the canine gastrocnemius tendon to bone and may be suitable for clinical use. Clinical Relevance— Tendon repairs with a gap >3 mm are reported to be at increased risk of rupture during the first 6 weeks postoperatively. A modified 3‐loop pulley pattern resists gap formation better than a locking‐loop pattern.