A knotless bidirectional-barbed tendon repair is inferior to conventional 4-strand repairs in cyclic loading

作者:O' Brien F P III; Parks B G; Tsai M A; Means K R Jr
来源:Journal of Hand Surgery-European Volume, 2016, 41(8): 809-814.
DOI:10.1177/1753193416631440

摘要

<jats:p> We divided 21 flexor digitorum profundus tendons in the index, middle and ring fingers in seven cadaver hands into three groups. The tendons were cut in zone 2 and repaired using a 4-strand cruciate core suture repair with one of the following three materials in each group: (1) a knotless repair with a 2-0 bidirectional-barbed suture, which has similar tensile strength as a 4-0 non-barbed suture used in the other two groups; (2) a knotted locking repair with a non-barbed 4-0 conventional suture; and (3) a non-locking repair with a non-barbed 4-0 knotless suture. The repaired fingers were cyclically loaded through a simulated active range of motion to a 5?N load. We monitored and recorded the gap sizes at regular intervals during the test. The 2-0 bidirectional-barbed suture group and non-barbed suture groups developed gaps of 2.2?mm after 10 cycles and 2.4?mm after 20 cycles, respectively. Over 1000 cycles, the mean gaps were 3.2?mm in the 4-0 conventional suture group and 9.1?mm in the 2-0 bidirectional-barbed group. The tendons in the 2-0 bidirectional-barbed group gapped earlier, with statistically significant differences compared with those in the locking repair with a non-barbed 4-0 knotless suture group. The repair strength of the barbed suture technique was inferior to the cruciate repairs using a conventional 4-0 non-barbed suture tested in this cyclic-loading model. </jats:p><jats:p> Level of evidence: Level V </jats:p>

  • 出版日期2016-10