History and Evolution of the Kessler Repair

Sebastin, Sandeep J.; Ho, Allison; Karjalainen, Teemu; Chung, Kevin C.

doi:10.1016/j.jhsa.2012.11.033

Cited by 48 publications

(33 citation statements)

References 32 publications

(35 reference statements)

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“…To evaluate the role of repair and immobilization/activity (IM/ACT) 6-weeks post-injury, animals were randomized into repaired or non-repaired groups, and further randomized into groups immobilized for 1, 3, or 6 weeks that later resumed cage and activity for 5, 3, or 0 weeks (IM1/ACT5, IM3/ACT3, IM6/ACT0) (Figure 1). Repairs were performed with the Urbaniak variant of the Kessler repair 23 using 4-0 Tevdek (PTFE coated) suture, as done previously. 12 Immobilization procedures consisted of casting the leg from below the knee to the toes in a fully plantarflexed position using silk tape stirrups (3M; St. Paul, MN), webril padding (Hanna Pharmaceutical; Wilmington, DE), a plastic splint (MakerBot Industries, LLC; Brooklyn, NY), CoFlex (Andover Healthcare; Salisbury, MA), and poly(methyl-methacrylate) (Patterson Dental; St. Paul, MN).…”

Section: Methodsmentioning

confidence: 99%

Temporal Healing of Achilles Tendons After Injury in Rodents Depends on Surgical Treatment and Activity

Freedman

Salka²,

Morris³

et al. 2017

J Am Acad Orthop Surg

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Introduction Achilles tendon ruptures affect 15 (women) to 55 (men) per 100,000 people each year, and controversy continues to exist regarding optimal treatment and rehabilitation protocols. The objective of this study was to investigate the temporal effects of surgical repair and immobilization/activity (IM/ACT) on Achilles healing and limb function following complete transection in rodents. Methods Injured tendons (n=128) were repaired or left non-repaired, and animals groups immobilized in plantarflexion for 1, 3, or 6 weeks that later resumed cage and treadmill activity for 5, 3, or 0 weeks (IM1/ACT5, IM3/ACT3, IM6/ACT0). Animals were euthanized after 1- or 6-weeks post-injury. Results At 6-weeks post injury, IM1/ACT5 groups had increased range of motion and decreased ankle joint toe stiffness compared to IM3/ACT3 groups. IM6/ACT0 had decreased tendon cross sectional area, but increased tendon echogenicity and collagen alignment. Surgical treatment dramatically decreased fatigue cycles to failure in repaired tendons from earlier IM1/ACT5 groups. Normalized comparisons between 6- and 1-week post-injury data demonstrated that changes in healing tendon properties (area, alignment, and echogenicity) were maximized by IM1/ACT5 compared to IM6/ACT0. Discussion/Conclusion This study demonstrates how the temporal post-injury healing response of rodent Achilles tendons depends on both surgical treatment and the timing of IM/ACT.

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Section: Methodsmentioning

confidence: 99%

Temporal Healing of Achilles Tendons After Injury in Rodents Depends on Surgical Treatment and Activity

Freedman

Salka²,

Morris³

et al. 2017

J Am Acad Orthop Surg

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“…Therefore we compared the forces needed to cheese-wire a uniform suture loop through human, pig and sheep deep flexor tendons. A 2 mm bite was chosen because this depth reflects a typical locking loop bite into the tendon substance used in most suture configurations, such as Kessler, 30) Tsuge, 31) Cruciate, 7) Cross Locked Cruciate (Adelaide) 16) or Tang 10) repair. A 2 mm bite is also the recommended minimum depth for any circumferential repair.…”

Section: Resultsmentioning

confidence: 99%

Animal Models for Tendon Repair Experiments: A Comparison of Pig, Sheep and Human Deep Flexor Tendons in Zone II

Peltz

Hoffman

Scougall

et al. 2017

J Hand Surg Asian-Pac Vol

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Background: This laboratory study compared pig, sheep and human deep flexor tendons in regards to their biomechanical comparability. Methods: To investigate the relevant biomechanical properties for tendon repair experiments, the tendons resistance to cheese-wiring (suture drag/splitting) was assessed. Cheese-wiring of a suture through a tendon is an essential factor for repair gapping and failure in a tendon repair. Results: Biomechanical testing showed that forces required to pulling a uniform suture loop through sheep or pig tendons in Zone II were higher than in human tendons. At time point zero of testing these differences did not reach statistical significance, but differences became more pronounced when forces were measured beyond initial cheese-wiring (2 mm, 5 mm and 10 mm). The stronger resistance to cheese-wiring was more pronounced in the pig tendons. Also regarding size and histology, sheep tendons were more comparable to human tendons than pig tendons. Conclusions: Differences in tendon bio-properties should be kept in mind when comparing and interpreting the results of laboratory tendon experiments.

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“…1), in which the knot is buried inside the tendon. 7,15 The knot lies in the transverse component of the suture, and the suture is anchored with 8 locking loops. Tendons of group 2 were repaired with a 4-strand Lahey repair.…”

Section: Repair and Materialsmentioning

confidence: 99%

Biomechanical Analysis of the Modified Kessler, Lahey, Adelaide, and Becker Sutures for Flexor Tendon Repair

Jordan

Schmitt

Jansen

et al. 2015

The Journal of Hand Surgery

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History and Evolution of the Kessler Repair

Cited by 48 publications

References 32 publications

Temporal Healing of Achilles Tendons After Injury in Rodents Depends on Surgical Treatment and Activity

Temporal Healing of Achilles Tendons After Injury in Rodents Depends on Surgical Treatment and Activity

Animal Models for Tendon Repair Experiments: A Comparison of Pig, Sheep and Human Deep Flexor Tendons in Zone II

Biomechanical Analysis of the Modified Kessler, Lahey, Adelaide, and Becker Sutures for Flexor Tendon Repair

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