Biomechanical Comparison of Tendon Coaptation Methods With a Meshed Suture Construct

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Musculoskeletal Research

Background:

• Secure tendon-to-tendon attachment constructs are crucial for early mobilization post-surgery in tendon reconstructions and transfers.
• Evaluating novel suture materials and techniques is essential to optimize biomechanical properties of tendon repairs.

Purpose of the Study:

• To biomechanically compare the strength, bulk, gliding resistance, and failure modes of two common tendon coaptation constructs.
• To evaluate the efficacy of a novel mesh suture against a traditional nonabsorbable braided suture in tendon repairs.

Main Methods:

• 100 cadaveric tendons were used to create five distinct tendon coaptation constructs.
• Constructs included Pulvertaft weave and single-pass, side-to-side (SP-STS) techniques with either mesh or braided sutures.
• Parameters assessed: tensile strength, construct bulk, gliding resistance, and failure type.

Main Results:

• No significant difference in coaptation bulk was observed between construct types or suture materials.
• SP-STS constructs demonstrated higher peak load, normalized peak load, and stiffness compared to Pulvertaft constructs.
• Gliding resistance was higher in SP-STS constructs with mesh suture compared to Pulvertaft constructs.

Conclusions:

• Single-pass, side-to-side (SP-STS) tendon coaptation constructs provide superior strength and stiffness over the Pulvertaft weave.
• While SP-STS constructs show increased gliding resistance, the mesh suture did not offer significant biomechanical benefits over braided sutures within construct groups.
• SP-STS constructs are a stronger alternative for tendon coaptation, but suture material choice may not impact outcomes.