Effect of Gap Size on Gliding Resistance After Flexor Tendon Repair

Zhao, Chunfeng; Amadio, Peter C.; Tanaka, Tatsuro; Kutsumi, Keiji; Tsubone, Tetsu; Zobitz, Mark E.; An, Kai Nan

doi:10.2106/00004623-200411000-00019

Cited by 82 publications

(65 citation statements)

References 40 publications

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“…The presence of significant statistical differences commencing after the initiation of the process in the S+H and S groups and beginning after the 0.5-mm gap formation in the H and S groups demonstrated a lack of gap delaying effect in the suturing techniques when used alone, which parallels the results in the literature (Fig. 3) (Table 2), [17,25]. As far as we are aware, there is one in vitro meniscus study [17] in which Histoacryl use in addition to the suture material was found to be the strongest method, as was found in our study.…”

Section: Discussionsupporting

confidence: 85%

“…5). Group H was stronger than group S by as much as 10 N. Chunfeng Zhoa et al [25] showed that in tendon repairs running sutures could tolerate loading until the formation of a gap of 2 mm, and then core sutures such as Kessler were loaded. All these findings lead us to the conclusion that, like the running sutures used in tendon repair, Histoacryl prevented direct loading of vertical mattress sutures, thus inhibiting gap formation at the beginning of traction.…”

Section: Discussionmentioning

confidence: 99%

“…As far as we are aware, there is one in vitro meniscus study [17] in which Histoacryl use in addition to the suture material was found to be the strongest method, as was found in our study. Failure strength was directly correlated with suture size and the size of the adhered area [3,6,25]. Koukoubis et al used 3/0 prolene in their study.…”

Section: Discussionmentioning

confidence: 99%

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Histoacryl glue in meniscal repairs (a biomechanical study)

Ayan

Çolak

Çömelekoğlu

et al. 2006

International Orthopaedics (SICOT)

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The purpose of this study was to investigate the biomechanical efficacy of Histoacryl (cyanoacrylate, Nasetil 2 butyl sistein) in meniscal tear repair. In our study, the primary stability of three different repair techniques in delaying the formation of a gap of 2 mm was investigated. A meniscal tear was repaired with two vertical sutures and Histoacryl in the first group; it was repaired only with Histoacryl in the second group, and with only two vertical sutures in the third group. Menisci were then placed in a tensile loading machine, and the primary stability of the repair zones was measured until a displacement of 2 mm occurred. Biomechanical force was significantly (P<0.05) high (112.0±17.20 N) in all groups when vertical suture and Histoacryl glue were used together during displacements of 0.5, 1.0, 1.5 and 2.0 mm. We believe that Histoacryl is superior to vertical sutures regarding gap delaying. It potentiates the effect of vertical suture strength, permits early motion and thus merits an in vivo study.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Histoacryl glue in meniscal repairs (a biomechanical study)

Ayan

Çolak

Çömelekoğlu

et al. 2006

International Orthopaedics (SICOT)

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show abstract

“…10 Furthermore, we found comparable 2-mm gap resistance in barbed versus similarly rated conventional sutures, which also corroborates with prior studies, 9 although the range of tensile strengths in other studies is vast due to the use of different sutures materials and ex vivo models. 2,3,15,19 In linear testing, the 2-mm gap resistance likely translates to a more clinically applicable figure than maximum tensile strength. In our samples, it appeared that maximum tensile strength of core sutures was reached after gapping over 10 mm, but prior studies have shown that 2-mm or larger gap formation during repaired flexor tendon mobilization significantly increases catching at the pulleys and gliding resistance.…”

Section: Discussionmentioning

confidence: 99%

“…In our samples, it appeared that maximum tensile strength of core sutures was reached after gapping over 10 mm, but prior studies have shown that 2-mm or larger gap formation during repaired flexor tendon mobilization significantly increases catching at the pulleys and gliding resistance. 19 Therefore, the ultimate tensile strength of the core sutures was reached long after the repair integrity was lost. Although gap resistance increased by adding a peripheral repair, maximum tensile strength of the core repair remained unaffected.…”

Section: Discussionmentioning

confidence: 99%

Does Barbed Suture Repair Negate the Benefit of Peripheral Repair in Porcine Flexor Tendon?

Sull

İnceoğlu

Wongworawat

2016

Hand (New York, N,Y.)

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Background: Advances in suture material and geometry have fueled interest in barbed suture tenorrhaphy. Theoretically, barbed suture allows better load distribution, smoother gliding under pulleys, and improved tendon blood flow. Minimal data exist on whether barbed tendon repair may benefit from supplementation by a peripheral stitch. The purpose of this study is to determine whether peripheral suture repair increases gap resistance in both conventional and barbed core repairs, increases maximum tensile strength, and fails before or after the core repair. Methods: Porcine flexor tendons were harvested and assigned randomly into 4 groups of 10 of varying suture constructs (3-0 PDS™ or 3-0 V-Loc 180™ core with or without peripheral 5-0 Vicryl™ repair). Core repairs were performed using a modified 4-strand cruciate repair. A servohydrolic tester was used for biomechanical testing of linear 2-mm gap resistance and maximum tensile strength. Results: Peripheral repair improved 2-mm gap resistance in all repairs, regardless of core suture type, conventional (173% increase) or barbed (204% increase). No change in the maximum tensile strength was found in either core suture type with peripheral repair. Peripheral repairs always failed before core repairs, at a significantly higher load of 74.2 ± 20.4 N in barbed versus 57.8 ± 12.2 N (P = .04) in conventional core repairs. Conclusions: The addition of peripheral repair improved gap resistance but not ultimate tensile strength in both conventional and barbed flexor tendon repairs in linear testing. The 4-strand cruciate flexor tendon repairs using barbed suture may require peripheral repair to withstand physiologic loads, as core repair alone using barbed suture was insufficient.

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Auto‐crosslinked hyaluronic acid gel accelerates healing of rabbit flexor tendons in vivo

Wit

Putter

Tra

et al. 2009

Journal Orthopaedic Research

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This study's purpose was to assess the in vivo effect of auto-crosslinked hyaluronic acid (HA) gel, a natural HA derivative with increased viscosity and tissue residence time, on adhesions and healing of injured and surgically repaired rabbit digital flexor tendons. The second and third right deep digital flexor tendons from 48 rabbits (n ¼ 96 tendons) were cut and repaired with a modified Kessler and running peripheral suture. Animals were randomized to two groups, receiving either HA gel or saline injected around both freshly repaired tendons. After 2, 3, 6, and 12 weeks, six rabbits in each group were euthanized. Tendon pull-out force and breaking strength were measured as a value for adhesion formation and tendon healing, respectively. A histological assessment of adhesions and healing was related to the mechanical results. A significantly faster increase in breaking strength was found in HA gel-treated compared to saline-treated tendons; this coincided with a significantly accelerated tissue repair response after injury. No significant difference in adhesion formation was found between the two groups at any time. Our results indicate a significant acceleration of in vivo healing of tendons treated with HA gel. Adhesion formation was unaffected. These results could have important clinical value in promoting rehabilitation after tendon injury. ß

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Effect of Gap Size on Gliding Resistance After Flexor Tendon Repair

Cited by 82 publications

References 40 publications

Histoacryl glue in meniscal repairs (a biomechanical study)

Histoacryl glue in meniscal repairs (a biomechanical study)

Does Barbed Suture Repair Negate the Benefit of Peripheral Repair in Porcine Flexor Tendon?

Auto‐crosslinked hyaluronic acid gel accelerates healing of rabbit flexor tendons in vivo

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