Effect of a continuous epitendinous suture as adjunct to three‐loop pulley and locking‐loop patterns for flexor tendon repair in a canine model

Putterman, Allison B.; Duffy, Daniel J.; Kersh, Mariana E.; Rahman, Hafizur; Moore, George E.

doi:10.1111/vsu.13268

Cited by 32 publications

(93 citation statements)

References 35 publications

(89 reference statements)

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“…13,17 One study showed that the addition of a continuous epitendinous suture pattern to the 3LP and LL suture patterns eliminated small gaps between the tendon ends and increased failure loads of both repair methods more than twofold. 16 To our knowledge, those techniques have not been used in cases with a wide, non-reducible gap, such as the 7 mm gap in the present case. Further studies are required to determine healing times as well as acquisition of adequate strength of the AT repair in cases with a wide gap.…”

Section: Discussionmentioning

confidence: 80%

“…5,7,13 The 3LP and the LL suture patterns have both been advocated for the repair of transected round or semiround tendons in dogs. 7,13,16,17 In one study, a modified 3LP suture pattern was found to be superior to the LL technique for reattaching canine tendon to bone and for reducing gap formation. 13 Barbed polypropylene suture material did not appear to provide a major benefit when used in a modified 3LP suture pattern.…”

Section: Discussionmentioning

confidence: 99%

“…It is possible that the additional suture passes of the epitendinous pattern could interfere with the blood supply to the tendon. 16 We instead chose an augmentation technique to strengthen and support the repair, to reduce the risk of adhesions, to shorten the postoperative immobilization period and to decrease the risk of a revision surgery. Free allogenous and autogenous grafts undergo rapid degradation and acquisition of adequate tendon strength depends on ingrowth of host tissue.…”

Section: Discussionmentioning

confidence: 99%

“…2,[5][6][7][8][9][10][11][12] Current repair techniques involve excision of fibrous scar tissue and reattachment of the common calcaneal tendon stumps with or without augmentation techniques. 6,7,9,[13][14][15][16] Suture patterns commonly used are the locking loop (LL), three-loop pulley (3LP), Bunnell-Mayer and Krackow. 7,14 The risk of gapping and suture pull-out are reduced by grasping and locking of collagen fibres within the tendon using the LL suture pattern and by multiple divergent needle passes using the 3LP suture pattern.…”

Section: Introductionmentioning

confidence: 99%

“…Methods used in dogs include autogenous tissue flaps derived from the semitendinosus muscle, fascia lata, fibularis brevis, fibularis longus and flexor digitorum lateralis tendons. 6,16,[18][19][20][21] Allogeneic grafts of porcine small intestinal submucosa have also been used to augment primary calcaneal tendon repair. 19 Synthetic implants such as polyethylene terephthalate, synthetic gastrocnemius tendon, carbon fibre mesh and poly-4-hydroxybutyrate (P4HB) mesh, as well as application of bone plates have been described for tendon repair.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Treatment of Common Calcaneal Tendon Rupture Using a Central Gastrocnemius Turnover Aponeurotic Flap Technique in a Dog

Minei¹,

Cinti²,

Pompei³

et al. 2020

VCOT Open

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A 9-year-old, intact male, German wirehaired pointer was referred for suspected Achilles tendon rupture 3 weeks after an injury. A three-loop pulley suture pattern combined with a locking loop suture reduced the gap between the tendon ends to 7 mm and a central gastrocnemius turnover aponeurotic flap was used to cover the remaining gap. A type II free-form methyl methacrylate transarticular external skeletal fixator was used to keep the tarsocrural joint in extension until 45 days postoperatively. Short- and long-term clinical and ultrasonographic evaluations showed gradual improvement in weight-bearing and progressive tendon healing. At 6 months after surgery, the dog had normal limb function and had returned to the previous activity level. To the authors' knowledge, this tendon repair technique has been described in humans and in one cat but has not yet been reported in dogs.

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Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Treatment of Common Calcaneal Tendon Rupture Using a Central Gastrocnemius Turnover Aponeurotic Flap Technique in a Dog

Minei¹,

Cinti²,

Pompei³

et al. 2020

VCOT Open

View full text Add to dashboard Cite

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Tendon Lacerations

Webb

2024

Techniques in Small Animal Soft Tissue, Orthopedic, and Ophthalmic Surgery

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Influence of Interlocking Horizontal Mattress Epitendinous Suture Placement on Tendinous Biomechanical Properties in a Canine Common Calcaneal Laceration Model

Cocca

Duffy

Kersh

et al. 2020

Vet Comp Orthop Traumatol

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Objective This article evaluates the effect of an interlocking horizontal mattress epitendinous suture (IHMES) in addition to a three-loop pulley (3LP) core suture for canine tendon repair. Study Design Twenty-eight cadaveric common calcaneal tendons were randomized, sharply transected and repaired with either a 3LP or 3LP + IHMES. Tensile loads required to create a 1- and 3-mm gap, yield, peak and failure loads, and mode of failure were analysed. Significance was set at p < 0.05. Results Mean ± standard deviation yield and failure force for 3LP + IHMES was 178.0 ± 45.3 N and 242.1 ± 47.8 N, respectively, which was significantly greater compared with 3LP alone, 97.9 ± 36.2 N and 119.3 ± 35.6 N (p < 0.0001). Occurrence of 3-mm gap formation was significantly less in the 3LP + IHMES group (p < 0.013). Mode of failure was significantly different between the groups (p < 0.001) with 3LP + IMHES patterns failing by suture breakage (13/14) compared with suture pull-through in the 3LP (11/14). Conclusion Addition of an epitendinous suture pattern significantly reduced gap formation between tendon ends and significantly increased loads at yield (1.8 × ), peak (2.0 × ) and failure (2.0 × ) force of repairs. Use of an epitendinous suture should be considered to significantly increase biomechanical strength of repairs; however, further in vivo testing is necessary to evaluate its effect on tendinous blood supply.

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Effect of a continuous epitendinous suture as adjunct to three‐loop pulley and locking‐loop patterns for flexor tendon repair in a canine model

Cited by 32 publications

References 35 publications

Treatment of Common Calcaneal Tendon Rupture Using a Central Gastrocnemius Turnover Aponeurotic Flap Technique in a Dog

Treatment of Common Calcaneal Tendon Rupture Using a Central Gastrocnemius Turnover Aponeurotic Flap Technique in a Dog

Tendon Lacerations

Influence of Interlocking Horizontal Mattress Epitendinous Suture Placement on Tendinous Biomechanical Properties in a Canine Common Calcaneal Laceration Model

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