Editorial Type:
Surgery

Effect of bite distance of an epitendinous suture from the repair site on the tensile strength of canine tendon constructs

Daniel J. Duffy 1Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27607

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 BVM&s, MS
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Christina J. Cocca 2Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL 61802

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 DVM
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Mariana E. Kersh 3Department of Mechanical Science and Engineering, College of Engineering, University of Illinois, Urbana, IL 61801

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 PhD
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Woojae Kim 3Department of Mechanical Science and Engineering, College of Engineering, University of Illinois, Urbana, IL 61801

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 MS
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George E. Moore 4Veterinary Administration, College of Veterinary Medicine, Purdue University, West Lafayette, IN 47906

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 DVM, PhD
DOI:
https://doi.org/10.2460/ajvr.80.11.1034
Volume/Issue:
Volume 80: Issue 11
Online Publication Date:
01 Nov 2019
Restricted access
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Abstract

OBJECTIVE

To evaluate effects of bite distance of an interlocking horizontal mattress epitendinous suture (IHMES) from the repair site on tensile strength of canine tendon repairs.

SAMPLE

72 canine cadaveric superficial digital flexor tendons (SDFTs).

PROCEDURES

Transverse tenotomy was performed, and SDFTs were repaired with a locking-loop construct (LL construct) or 3 LL constructs with IHMES suture bites placed 5 (LL + 5ES construct), 10 (LL + 10ES construct), or 15 (LL + 15ES construct) mm from the transection site (18 SDFTs/group). Constructs were loaded to failure. Load at 1− and 3-mm gapping, yield force, failure load, and failure mode were evaluated.

RESULTS

Mean ± SD yield force and failure load for LL constructs were significantly lower than for IHMES constructs. Load at 1− and 3-mm gapping was significantly higher for IHMES constructs. Increasing the bite distance significantly increased construct strength (134.4 ± 26.1 N, 151.0 ± 16.8 N, and 182.1 ± 23.6 N for LL + 5ES, LL + 10ES, and LL + 15ES constructs, respectively), compared with strength for the LL construct. Failure mode differed significantly among constructs when an IHMES was used.

CONCLUSIONS AND CLINICAL RELEVANCE

Addition of an IHMES to an LL construct led to increased ultimate tensile strength by 2.5 times and significantly reduced gap formation. Increasing the IHMES bite distance increased yield force by 2.1, 2.3, and 2.7 times for bites placed 5, 10, and 15 mm from the tenotomy, respectively. Positioning an IHMES at a greater distance from the repair site provided superior biomechanical strength for tendon repairs in dogs.

Abstract

OBJECTIVE

To evaluate effects of bite distance of an interlocking horizontal mattress epitendinous suture (IHMES) from the repair site on tensile strength of canine tendon repairs.

SAMPLE

72 canine cadaveric superficial digital flexor tendons (SDFTs).

PROCEDURES

Transverse tenotomy was performed, and SDFTs were repaired with a locking-loop construct (LL construct) or 3 LL constructs with IHMES suture bites placed 5 (LL + 5ES construct), 10 (LL + 10ES construct), or 15 (LL + 15ES construct) mm from the transection site (18 SDFTs/group). Constructs were loaded to failure. Load at 1− and 3-mm gapping, yield force, failure load, and failure mode were evaluated.

RESULTS

Mean ± SD yield force and failure load for LL constructs were significantly lower than for IHMES constructs. Load at 1− and 3-mm gapping was significantly higher for IHMES constructs. Increasing the bite distance significantly increased construct strength (134.4 ± 26.1 N, 151.0 ± 16.8 N, and 182.1 ± 23.6 N for LL + 5ES, LL + 10ES, and LL + 15ES constructs, respectively), compared with strength for the LL construct. Failure mode differed significantly among constructs when an IHMES was used.

CONCLUSIONS AND CLINICAL RELEVANCE

Addition of an IHMES to an LL construct led to increased ultimate tensile strength by 2.5 times and significantly reduced gap formation. Increasing the IHMES bite distance increased yield force by 2.1, 2.3, and 2.7 times for bites placed 5, 10, and 15 mm from the tenotomy, respectively. Positioning an IHMES at a greater distance from the repair site provided superior biomechanical strength for tendon repairs in dogs.

Contributor Notes

Address correspondence to Dr. Duffy (djduffy@ncsu.edu).
Cover American Journal of Veterinary Research
American Journal of Veterinary Research
Publication Date:
01 Nov 2019

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