Investigation of locking configurations for tendon repair.

PURPOSE

Locking sutures have proven beneficial to the strength of the repaired tendon. In this study we investigated the effects of 3 locks in the tendon-suture junction and their effect on repair strength.

METHODS

Forty-seven fresh pig flexor tendons were transected and repaired using 4-strand repairs with 3 different configurations of locks in each tendon-suture junction: 1 exposed cross-lock, 1 embedded cross-lock, and 1 circle lock. The tendons were subjected to a linear noncyclic load-to-failure test using a tensile testing machine. The initial gap, the 2-mm gap force, and the ultimate strength were measured to compare the biomechanical performance for each repair.

RESULTS

Despite noticeable differences in the configurations of locks the gap formation force and ultimate strength were not significantly different among the 3 tested locking configurations.

CONCLUSIONS

An exposed cross-lock, an embedded cross-lock, and a circle lock at tendon-suture junctions had similar locking power. Circle-lock repairs without cross-locking components produce tensile strength similar to cross-locking repairs. The findings of this study suggest that the creation of cross-configurations in locking repairs used conventionally by many surgeons is not essential to repair strength and that circle locking is as efficient as cross-locking in the repair of lacerated flexor tendons.