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A Novel Tenorrhaphy Suture Technique with Tissue Engineered Collagen Graft to Repair Large Tendon Defects
Published on: December 10, 2021
[Tendon holding capacities of the suture materials used in repairing Achilles tendon rupture]
Yakup Yildirim1, Baransel Saygi, Hasan Kara
1Acibadem Hastanesi Ortopedi ve Travmatoloji Bölümü. yyildirim@asg.com.tr
Objectives:
We evaluated tendon holding capacities of suture materials that are commonly used in repair of Achilles tendon ruptures.
Methods:
Achilles tendons of 60 sheep were removed by incisions 2-cm proximal to the calcaneal insertion and 1-cm distal to the musculotendinous junction. The tendons were randomly divided into six groups and sutures were placed with the Kessler technique at the distal end of the tendons using one of the following suture materials: 2 polydioxanone (PDS), 1 PDS, 2 Vicryl, 1 Vicryl, 2 Ethibond, and 1 Prolene. The distal end of the suture material was left free. Each specimen was mounted in an Instron machine, with the tendon being placed proximally and the suture material distally. The system was loaded with a displacement rate of 20 mm/min.
Results:
Failure of all the specimens was due to pull-out of the suture material through the tendon. There were no failures due to suture breakage. The highest and the lowest tendon holding capacities were found with 2 PDS and 2 Ethibond sutures, respectively.
Conclusion:
Following Achilles tendon repair, the healing period, in particular the first three weeks, is precarious for pull-out of the suture material through the tendon. Thus, tendon holding capacity of the suture material is an important factor for the strength of the repair. Among the tested suture materials, 2 PDS was found to have the highest tendon holding capacity.
