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Effect of partial vs complete circumferential epitendinous suture placement on the biomechanical properties and gap formation of canine cadaveric tendons
Author(s) -
Duffy Daniel J.,
Chang YiJen,
Fisher Matthew B.,
Moore George E.
Publication year - 2020
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/vsu.13494
Subject(s) - cadaveric spasm , medicine , fibrous joint , core (optical fiber) , anatomy , surgery , orthodontics , materials science , composite material
Objective To determine the effect of partial vs complete circumferential epitendinous suture (ES) placement in addition to a core suture on the biomechanical strength and gapping characteristics of repaired canine tendinous constructs. Study design Ex vivo, biomechanical study. Sample population Thirty‐six canine superficial digital flexor tendons. Methods Superficial digital flexor tendons were randomly assigned to three groups (n = 12), sharply transected and repaired with a core locking‐loop suture with Group 1 a partial circumferential ES, 180° on the palmar side; Group 2 a complete circumferential ES, 360° and double knotting technique; or Group 3 a complete circumferential ES, 360° and single knotting technique. After preloading, constructs were distracted to monotonic failure. Failure mode, gap formation, yield, peak, and failure forces were analyzed. Results Mean yield (group 1 = 68.6 N, group 2 = 106.5 N, group 3 = 114 N, P < .013), peak (group 1 = 92.8 N, group 2 = 134.6 N, group 3 = 147.3 N; P < .001), and failure (group 1 = 88.7 N, group 2 = 133.0 N, group 3 = 145.5 N, P < .001) loads differed between groups. No difference in yield ( P = .874), peak ( P = .434), or failure load ( P = .434) was detected between complete circumferential ES groups. Force to create 1‐mm ( P < .001) and 3‐mm ( P < .038) gap formation was greater in specimens with complete vs partial circumferential ES placement. Complete circumferential ES repairs failed primarily by suture pull‐through compared with suture breakage in most partial circumferential ES constructs. Conclusion Addition of a complete circumferential ES with a single or double knotting technique increased the biomechanical strength of normal tendon repairs while reducing gap formation compared with partial ES placement alone. Clinical significance Complete circumferential ES is recommended over partial ES placement.