A novel method for reducing gap formation in tendon repair

Dean, Ryan

doi:10.1016/j.jor.2018.01.054

Journal of Orthopaedics

2018

DOI: 10.1016/j.jor.2018.01.054

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A novel method for reducing gap formation in tendon repair

Ryan Dean

Abstract: Decreasing early gap formation may be beneficial in allowing early rehabilitation and range of motion.

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Cited by 2 publications

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“…2 Over the last few decades, various graft materials and preparation techniques have been formulated for tendon graft reconstruction. [3][4][5][6][7] In DRUJ reconstruction, these include tendon only, braided nonabsorbable suture only, or tendon augmented with braided nonabsorbable suture. To date, there are no specific guidelines for the preferred suture preparation technique for use in soft tissue tendon grafts.…”

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confidence: 99%

Biomechanical Comparison of Distal Radioulnar Joint Reconstruction Graft Preparation Techniques

Li,

Beaudry,

Besada

et al. 2023

J Wrist Surg

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Background Graft preparation techniques for the Adams–Berger distal radioulnar joint (DRUJ) reconstruction vary among surgeons with insufficient evidence to support any specific technique. Questions/Purposes We compared survival with cyclic loading, absolute elongation, elongation rate, and modes of failure of four graft preparation techniques. Methods Fifteen porcine extensor tendons were divided into three equal groups: tendon only; tendon augmented along its full length with nonlocking 2–0 FiberLoop suture spaced at 6 mm intervals; and tendon with suture at 12 mm intervals. Suture only was also tested. Samples were woven through custom radius- and ulna-simulating jigs mounted on a mechanical testing machine. Samples underwent a staircase cyclic loading protocol and were then inspected visually for the mode of failure. Survival with cyclic loading, absolute elongation, and elongation rate was compared. Results Average survival with cyclic loading of suture-augmented tendon was significantly higher than tendon only. All tendon groups had significantly higher survival compared with suture only. Absolute elongation was subject to variability due to initial nonlinear elongation behavior of samples. The elongation rate was significantly lower with suture compared with all tendon groups. Modes of failure included rupture of the tendon and/or suture at the simulated graft–bone interface and elongation of the entire construct without rupture. Conclusions In this biomechanical study, augmentation of porcine tendons with suture spaced at either 6 or 12 mm for DRUJ reconstruction significantly increased survival to a staircase cyclic loading protocol Clinical Relevance For the Adams–Berger reconstruction, tendon grafts augmented along their entire length by nonabsorbable braided suture are biomechanically superior to tendon alone.

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mentioning

confidence: 99%

Biomechanical Comparison of Distal Radioulnar Joint Reconstruction Graft Preparation Techniques

Li,

Beaudry,

Besada

et al. 2023

J Wrist Surg

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Partial weight‐bearing and range of motion limitation significantly reduce the loads at medial meniscus posterior root repair sutures in a cadaveric biomechanical model

Sukopp,

Schwab,

Schwer

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeThe aim of this study was to investigate the influence of medial meniscus posterior root avulsion (MMPRA) before and after surgical treatment on the biomechanics of the knee joint, including suture repair forces during daily and crutch‐assisted gait movements.MethodsMMPRA were investigated in eight human cadaver knee joint specimens by a dynamic knee joint simulator with daily (normal gait, gait with additional rotational movement, standing up, sitting down) and rehabilitation‐associated movements (crutch‐assisted gait with limited flexion range of motion [30°] and 30% [toe‐touch weight‐bearing, TTWB] and 50% of body weight [partial weight‐bearing, PWB]) with simulated physiologic muscle forces. Each specimen was tested in intact, torn and repaired (transtibial suture) state. The biomechanical parameters were: medial mean contact pressure and area, knee joint kinematics, medial displacement of the posterior meniscus horn and loading on the anchoring suture.ResultsSignificant reduction of the contact area due to the avulsion was observed in all movements except for PWB and sitting down. MMPRA repair significantly increased the contact areas during all movements, bringing them to levels statistically indistinguishable from the initial state. MMPRA resulted in a medial displacement up to 12.8 mm (sitting down) and could be reattached with a residual displacement ranging from 0.7 mm (PWB) to 5.7 mm (standing up), all significantly (p < 0.001) reduced compared to the torn state. The mean peak anchoring suture load increased from TTWB (77 N), PWB (91 N) to normal gait (194 N), gait rotation (207 N), sitting (201 N; p < 0.01) and to standing up (232 N; p = 0.03).ConclusionSurgical treatment of MMPRA allows restoration of physiological knee joint biomechanics. Crutch‐assisted movements reduce the loading of the repair suture, thus likewise the risk for failure. From a biomechanical point of view, crutch‐assisted movements are recommended for the early rehabilitation phase after MMPRA repair.Level of EvidenceLevel V.

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A novel method for reducing gap formation in tendon repair

Abstract: Decreasing early gap formation may be beneficial in allowing early rehabilitation and range of motion.

Cited by 2 publications

References 15 publications

Biomechanical Comparison of Distal Radioulnar Joint Reconstruction Graft Preparation Techniques

Biomechanical Comparison of Distal Radioulnar Joint Reconstruction Graft Preparation Techniques

Partial weight‐bearing and range of motion limitation significantly reduce the loads at medial meniscus posterior root repair sutures in a cadaveric biomechanical model

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