Effect of bite depth of an epitendinous suture on the biomechanical strength of repaired canine flexor tendons

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

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Yi-Jen Chang 1Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27607

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Lewis S. Gaffney 2Joint Department of Biomedical Engineering, North Carolina State University and University of North Carolina–Chapel Hill, Raleigh, NC 27695

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Matthew B. Fisher 2Joint Department of Biomedical Engineering, North Carolina State University and University of North Carolina–Chapel Hill, Raleigh, NC 27695

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George E. Moore 3Veterinary Administration, College of Veterinary Medicine, Purdue University, West Lafayette, IN 47906

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Abstract

OBJECTIVE

To determine effects of bite depth for placement of an epitendinous suture on the biomechanical strength and gap formation of repaired canine tendons.

SAMPLE

48 superficial digital flexor tendons (SDFTs) obtained from 24 canine cadavers.

PROCEDURES

Tendons were assigned to 3 groups (16 tendons/group). Each SDFT was transected and then repaired with a continuous epitendinous suture placed with a bite depth of 1, 2, or 3 mm for groups 1, 2, and 3, respectively. Specimens were loaded to failure. Failure mode, gap formation, yield force, peak force, and failure force were analyzed.

RESULTS

Yield, peak, and failure forces differed significantly between groups 1 and 3 and groups 2 and 3 but not between groups 1 and 2. Comparison of the force resisted at 1 and 3 mm of gapping revealed a significant difference between groups 1 and 3 and groups 2 and 3 but not between groups 1 and 2. Failure mode did not differ among groups; suture pull-through occurred in 43 of 48 (89.6%) specimens.

CONCLUSIONS AND CLINICAL RELEVANCE

Increasing bite depth of an epitendinous suture toward the center of the tendon substance increased repair site strength and decreased the incidence of gap formation. Repair of tendon injuries in dogs by use of an epitendinous suture with bites made deep into the tendon should result in a stronger repair, which potentially would allow loading and rehabilitation to begin sooner after surgery. Suture techniques should be investigated in vivo to determine effects on tendinous healing and blood supply before clinical implementation.

Abstract

OBJECTIVE

To determine effects of bite depth for placement of an epitendinous suture on the biomechanical strength and gap formation of repaired canine tendons.

SAMPLE

48 superficial digital flexor tendons (SDFTs) obtained from 24 canine cadavers.

PROCEDURES

Tendons were assigned to 3 groups (16 tendons/group). Each SDFT was transected and then repaired with a continuous epitendinous suture placed with a bite depth of 1, 2, or 3 mm for groups 1, 2, and 3, respectively. Specimens were loaded to failure. Failure mode, gap formation, yield force, peak force, and failure force were analyzed.

RESULTS

Yield, peak, and failure forces differed significantly between groups 1 and 3 and groups 2 and 3 but not between groups 1 and 2. Comparison of the force resisted at 1 and 3 mm of gapping revealed a significant difference between groups 1 and 3 and groups 2 and 3 but not between groups 1 and 2. Failure mode did not differ among groups; suture pull-through occurred in 43 of 48 (89.6%) specimens.

CONCLUSIONS AND CLINICAL RELEVANCE

Increasing bite depth of an epitendinous suture toward the center of the tendon substance increased repair site strength and decreased the incidence of gap formation. Repair of tendon injuries in dogs by use of an epitendinous suture with bites made deep into the tendon should result in a stronger repair, which potentially would allow loading and rehabilitation to begin sooner after surgery. Suture techniques should be investigated in vivo to determine effects on tendinous healing and blood supply before clinical implementation.

Contributor Notes

Address correspondence to Dr. Duffy (djduffy@ncsu.edu).
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