Related Experiment Video
Updated: Apr 15, 2026
Using Q Suture to Enhance Resistance to Gap Formation and Tensile Strength of Repaired Flexor Tendons
Published on: June 3, 2020
The effect of barbed suture tendon repair on work of flexion
Oded Ben-Amotz1, Jennifer Kargel1, Brian Mailey1
1Department of Plastic Surgery, University of Texas Southwestern Medical Center at Dallas, Dallas, TX.
Purpose:
To compare the work of flexion, ultimate strength, and gap resistance of a conventional 4-strand tendon repair to a knotless barbed-suture 4-strand tendon repair.
Methods:
Tendon repairs were performed on 16 cadaver flexor digitorum profundus tendons using either a 4-strand double Kessler repair or a similar but knotless 4-strand repair with a unidirectional barbed suture. Work of flexion, gap resistance during cyclical loading, and ultimate strength of both techniques were determined and their means compared.
Results:
There was no difference in mean maximum load and gap formation between the 2 techniques. Work of flexion was higher for the barbed-suture repair group compared with the traditional repair group (39 N·mm vs 31 N·mm).
Conclusions:
The higher work of flexion in the barbed-suture group suggests that barbed suture may negatively affect tendon gliding within the flexor tendon sheath.
Clinical Relevance:
Knotless barbed-suture tendon repair leads to increased work of flexion compared with traditional flexor tendon repairs, which may result in an increased rupture incidence.
