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Sutured tendon repair; a multi-scale finite element model.

Shelley D Rawson1, Lee Margetts, Jason K F Wong

  • 1E12, Materials Science Centre, University of Manchester, Oxford Road, Grosvenor Street, Manchester, M1 7HS, UK.

Biomechanics and Modeling in Mechanobiology
|May 21, 2014
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Summary

High-strength sutures in tendon repair create altered stress distributions. A 3D finite element model revealed high stress near anchors and stress shielding at tendon ends, potentially impacting healing.

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Area of Science:

  • Biomechanics
  • Biomaterials Science
  • Orthopedic Surgery

Background:

  • Tendon ruptures require surgical repair to restore function.
  • High-strength sutures enable early active mobilization, improving joint mobility.
  • Suture techniques alter the local mechanical environment of the tendon, with unknown consequences.

Purpose of the Study:

  • To investigate the stress distribution around Kessler suture repairs in tendons.
  • To understand the biomechanical effects of suture placement on tendon healing.
  • To model the microstructural and orthotropic behavior of tendon tissue during repair.

Main Methods:

  • Developed a 3D finite element model of a Kessler suture repair.
  • Employed multiscale modeling to represent tendon microstructure.
  • Incorporated tendon's orthotropic behavior, informed by ex vivo tensile testing of porcine flexor digitorum profundus tendon.

Main Results:

  • Observed an elliptical high-stress region around the suture anchor.
  • Identified a stress-shielded region near severed tendon ends.
  • Characterized transverse and interfibrillar tissue moduli of porcine tendon samples.

Conclusions:

  • Suture repairs create localized stress concentrations and shielded areas.
  • These altered stress distributions may impede optimal collagen fiber realignment during tendon healing.
  • Finite element modeling provides crucial insights into the biomechanics of tendon repair.