Tensile strength comparison of dowel plug technique to standard techniques of tendon-bone attachment

Since tendon transplantation relies on successful fixation of the tendon transplant, a quantitative comparison of various methods of tendon attachment to bone was investigated in mongrel dogs. The methods included attaching tendon to periosteum, suturing a tendon to itself after passing through bone, stapling, and wedging a dowel plug into a hole with the tendon. Tests to failure were conducted at 0, 10, 28, and 63 days of healing. The dowel plug technique provided strong immediate fixation. After 63 days the staple, the tendon passed through bone, and the dowel plug techniques showed significant increases in strength. On tendons of similar size, the dowel plug method showed the greatest tensile strength when compared to the staple fixation. This method was a simple, reproducible technique.