Related Experiment Video
Updated: Aug 25, 2026
A Novel Tenorrhaphy Suture Technique with Tissue Engineered Collagen Graft to Repair Large Tendon Defects
Published on: December 10, 2021
The three-loop pulley suture versus two locking-loop sutures for the repair of canine achilles tendons
Andy P Moores1, Martin R Owen, John F Tarlton
1Department of Clinical Veterinary Science, University of Bristol, Langford House, Langford, Bristol, UK. andy.moores@bristol.ac.uk
Objective:
To compare a 3-loop pulley suture pattern with 2 locking-loop sutures for the repair of components of the canine Achilles mechanism.
Study Design:
In vitro biomechanical study.
Animals:
Forty-eight paired tendons collected from 9 canine cadavers.
Methods:
Paired tendons were repaired with either a 3-loop pulley suture or 2 locking-loop sutures and tensile tested to failure. To ensure accurate anastomosis gap measurement a direct, non-contact, method of gap measurement, using digital video, was devised. Load initiating gap formation (defined as load at a 1 mm gap) and load producing a 3 mm gap were evaluated in addition to maximum load, gap at failure, mode of failure, and time spent placing the sutures.
Results:
Maximum load values were similar for both repairs. The mean 1 mm gap loads were 44.0 and 18.4 N, and the mean 3 mm gap loads were 56.3 and 34.7 N, for the 3-loop pulley pattern and the 2 locking-loops, respectively; these differences were statistically significant. The 3-loop pulley pattern was faster to place and resulted in a smaller gap at failure. All but 2 repairs failed by suture pull out.
Conclusions:
The 3-loop pulley pattern is more resistant to gap formation during tensile loading, and is quicker to place, than 2 locking-loop sutures.
Clinical Relevance:
Gap formation can significantly delay tendon healing. Tendon repairs with a gap >3 mm are reported to be at increased risk of rupture during the first 6 weeks postoperatively.
