In Vitro Biomechanical Comparison of Polypropylene Mesh, Modified Three‐Loop Pulley Suture Pattern, and a Combination for Repair of Distal Canine Achilles' Tendon Injuries

Gall, Trent T.; Santoni, Brandon G.; Egger, Erick L.; Puttlitz, Christian M.; Rooney, Matthew B.

doi:10.1111/j.1532-950x.2009.00598.x

Cited by 44 publications

(100 citation statements)

References 15 publications

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“…Repairs with gapping <3 mm have been associated with greater ultimate force, repair‐site rigidity, and accrual of repair site strength and stiffness between 10 and 42 days postoperatively . In addition, gap formation impairs healing and uniform collagen fibril alignment and is a major cause of adhesion formation . In our study, constructs incorporating ES were more resistant to gapping and required a force 2.2‐fold and 2.4‐fold greater than the force required in core LL patterns to create a 1‐ and 3‐mm gap, respectively.…”

Section: Discussionmentioning

confidence: 56%

Biomechanical comparison of three epitendinous suture patterns as adjuncts to a core locking loop suture for repair of canine flexor tendon injuries

et al. 2019

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Objective To determine the effects of different epitendinous sutures (ES) in addition to core locking‐loop (LL) sutures on the mechanical properties and gap formation in a canine cadaveric tendon model. Study design Experimental, ex vivo, biomechanical study. Sample population Seventy‐two cadaveric superficial digital flexor tendon specimens. Methods Superficial digital flexor tendon specimens were divided into four groups (n = 18): sharply transected and repaired with LL, LL + simple continuous ES, LL + Silfverskiöld cross‐stitch ES, and LL + interlocking horizontal mattress ES. Constructs were loaded to monotonic failure. Failure modes, gapping, yield, peak, and failure forces were analyzed. Significance was set at P < .05. Results Yield, peak, and failure forces increased by 2.5‐fold, two‐fold, and twofold, respectively when ES groups were compared with core LL suture patterns alone (P < .0001). Resistance to 1‐ and 3‐mm gap formation was greater in ES groups compared with core LL constructs alone (P < .0001). No differences in yield, peak, failure force, or gapping were observed among ES patterns (P > .827). Conclusion Adding an ES reduced gap formation and increased yield, peak, and failure forces of tenorrhaphies. No difference was detected between the epitendinous patterns tested in this study. Clinical significance The addition of an ES seems more relevant than the specific type of pattern to improve the biomechanical properties of flexor tendon repairs. In vivo studies are warranted to determine the biological implications of the patterns tested here.

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Section: Discussionmentioning

confidence: 56%

Biomechanical comparison of three epitendinous suture patterns as adjuncts to a core locking loop suture for repair of canine flexor tendon injuries

et al. 2019

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“…Suture patterns described for tenorrhaphy in dogs include the three‐loop pulley (3LP), Krackow or locking‐loop (LL), continuous cruciate, Bunnell‐Mayer, Mason‐Allen, vertical mattress, and simple interrupted . The patterns most commonly used for primary tendinous repair in dogs are the 3LP or LL .…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2019

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Objective To evaluate the effect of combining a continuous epitendinous suture with three‐loop pulley (3LP) and locking‐loop (LL) core patterns for flexor tendon repair. Study design Ex vivo biomechanical study. Sample population Seventy‐two cadaveric superficial digital flexor musculotendon (SDFT) units. Methods Tendons were divided into four groups (n = 18/group). After sharp transection, SDFT were repaired with 3LP, LL, 3LP + epitendinous (E), or LL + E suture patterns. After preloading, repaired constructs were tested to failure. Video data acquisition allowed evaluation of failure mode and quantitation of gap formation. Yield, peak, and failure force were measured from force‐displacement data. Significance was set at P < .05. Results Mode of failure did not differ between repairs with or without an epitendinous suture (P = .255). Gap formation was best prevented with 3LP compared with LL when used alone (P = .001). Mean yield force for 3LP, LL, 3LP + E, and LL + E were 91.4 N ± 25.4, 61.3 N ± 18.4, 195.2 N ± 66.0, 165.3 N ± 46.8, respectively. Tenorrhaphies combined with an epitendinous suture achieved higher yield (P < .0001), peak (P < .0001), and failure forces (P < .0001), without gapping between tendon ends. Conclusion Addition of an epitendinous suture eliminated gapping between tendon ends until failure and increased resistance to loads tolerated at the repair site. Clinical significance The addition of an epitendinous suture may increase the strength of tendon repairs and resistance to gap formation over core suture use alone. The influence of epitendinous suture placement on tendinous healing and blood supply warrants in‐vivo testing.

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“…) and Achilles tendon rupture (Gall et al . ). The mesh is a taffeta weave of monofilament fibres with a large pore size (200‐800 µm) allowing capillary and fibrous tissue in‐growth into the mesh (Bowman et al .…”

Section: Discussionmentioning

confidence: 97%

“…Polypropylene mesh has been used in dogs to augment repair of perineal hernias, thoracic and abdominal wall defects, tracheal defects (Szabo et al 2007) and Achilles tendon rupture (Gall et al 2009). The mesh is a taffeta weave of monofilament fibres with a large pore size (200-800 µm) allowing capillary and fibrous tissue in-growth into the mesh (Bowman et al 1998).…”

Section: Discussionmentioning

confidence: 99%

Bilateral medial displacement of the biceps tendon of origin: repair using polypropylene mesh and staples

Barnes

2013

J of Small Animal Practice

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A three-year-old male greyhound was presented with acute onset right forelimb lameness because of medial displacement of the biceps tendon of origin. Ultrasonographic examination confirmed the diagnosis, and a concomitant partial tear of the medial glenohumeral ligament was detected during arthroscopy. To stabilise the biceps tendon, polypropylene mesh was fixed across the intertubercular groove to replace the torn transverse humeral retinaculum. Recovery was uneventful and lameness resolved. Fifteen months later, the dog was presented with medial displacement of the biceps tendon of origin of the left shoulder, and was treated successfully using the same technique.

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In Vitro Biomechanical Comparison of Polypropylene Mesh, Modified Three‐Loop Pulley Suture Pattern, and a Combination for Repair of Distal Canine Achilles' Tendon Injuries

Abstract: Achilles' ruptures repaired with suture can be augmented with mesh to increase the ultimate load to failure, but as currently tested, there was a decrease in resistance to gap formation At this time we cannot recommend Mesh or the Suture+Mesh techniques without further testing.

Cited by 44 publications

References 15 publications

Biomechanical comparison of three epitendinous suture patterns as adjuncts to a core locking loop suture for repair of canine flexor tendon injuries

Biomechanical comparison of three epitendinous suture patterns as adjuncts to a core locking loop suture for repair of canine flexor tendon injuries

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

Bilateral medial displacement of the biceps tendon of origin: repair using polypropylene mesh and staples

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