Assistant Professor Small Animal Orthopedics North Carolina State University, North Carolina
Effect of Epitendinous Suture Caliber on the Biomechanical Properties of Flexor Tendon Repairs in a Canine Cadaveric Model. Duffy DJ1, Chang Y1, Chambers A1, Fisher M1, Moore G2. 1North Carolina State University, Raleigh, NC; 2Purdue University, West Lafayette, IN.
Tendon repair strength is influenced by use of core and epitendinous suture (ES) patterns in both dogs and human patients requiring repair. In people, larger caliber core sutures have been shown to improve construct strength and decrease gap formation. The objective of this study was to evaluate the effect of ES size using a simple continuous pattern without the addition of a core suture in a canine flexor tendon model. We hypothesized that increasing the size/caliber of ES used for repair would increase yield, peak, and failure forces and decrease the occurrence of gap formation at the repair site. There was a positive correlation between suture size and yield, peak, and failure forces (P < 0.001) respectively. Use of larger suture sizes increased the force required to cause 1 mm gapping (P < 0.001) while decreasing the occurrence of 3 mm gapping. Corroborating with results of previous studies regarding core suture use for flexor tendon surgery of the human hand. Increasing core suture size significantly increased construct strength while decreasing the occurrence of 3 mm gap formation. Limitations of this study include the ex vivo nature and use of ES alone without concurrent evaluation of a core suture. Based on our results, use of the largest ES size possible should be recommended to increase repair-site strength and increase loads required to cause 3 mm gapping.