Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA.
Joint Department of Biomedical Engineering, North Carolina State University and the University of North Carolina - Chapel Hill, Raleigh, North Carolina, USA.
Vet Surg. 2021 Aug;50(6):1316-1325. doi: 10.1111/vsu.13678. Epub 2021 Jul 6.
To compare the biomechanical properties and gapping characteristics of four novel tenorrhaphy patterns in a canine flexor tendon model.
Ex vivo, randomized, biomechanical study.
Superficial digital flexor tendons of 60 forelimbs (30 dogs).
Each tendon was transected 25 mm distal to its musculotendinous junction prior to tenorrhaphy with 2-0 polypropylene. Repair patterns included the three-loop pulley (3LP, control), exposed double-cross-lock (ExDCrL), embedded double-cross-lock (EmDCrL), triple-circle-lock (TCiL), and Modified-Tang patterns (MTang) were randomly assigned to each experimental group (n = 12/group). Yield, peak, and failure loads, gap formation and failure modes were compared.
Tendons repaired with ExDCrL (p < .0001), EmDCrL (p < .0001), and MTang (p < .0001) sustained yield, peak, and failure loads ~2.2x, ~2.0x, and ~1.9x, respectively, greater than those repaired with 3LP. Loads to 1 and 3 mm gapping were also higher for ExDCrL (p < .0001), EmDCrL (p < .0004), and MTang constructs (p < .0017) compared to 3LP. Although TCiL constructs sustained higher loads, their resistance to gap formation did not differ from that of 3LP repairs. Failure mode differed between groups (p < .0001), EmDCrL, ExDCrL, MTang, and TCiL constructs failing predominantly by suture breakage compared to 3LP repairs that failed by suture pull-through.
Use of novel patterns ExDCrL, EmDCrL, and MTang improved resistance to loads and gap formation and were biomechanically superior compared to 3LP in healthy canine tendon repairs.
These results justify in vivo evaluation of ExDCrL, EmDCrL, or MTang pattern for tenorrhaphy in dogs.
比较四种新型腱缝合模式在犬屈肌腱模型中的生物力学特性和间隙特征。
离体、随机、生物力学研究。
60 个前肢（30 只狗）的浅层指屈肌腱。
在肌腱近节指骨-肌腱结合部 25mm 处切断，用 2-0 聚丙烯缝线进行腱缝合。修复模式包括三圈滑轮（3LP，对照）、暴露双十字锁（ExDCrL）、嵌入式双十字锁（EmDCrL）、三环锁（TCiL）和改良 Tang 模式（MTang），随机分配到每个实验组（n=12/组）。比较屈服、峰值和失效载荷、间隙形成和失效模式。
用 ExDCrL（p<.0001）、EmDCrL（p<.0001）和 MTang（p<.0001）修复的肌腱，屈服、峰值和失效载荷分别约为 3LP 的 2.2 倍、2.0 倍和 1.9 倍。与 3LP 相比，ExDCrL（p<.0001）、EmDCrL（p<.0004）和 MTang 结构的 1mm 和 3mm 间隙形成的加载也更高。虽然 TCiL 结构的承受的载荷较高，但它们的间隙形成阻力与 3LP 修复没有差异。各组之间的失效模式不同（p<.0001），EmDCrL、ExDCrL、MTang 和 TCiL 结构主要通过缝线断裂失效，而 3LP 修复则通过缝线拉脱失效。
新型 ExDCrL、EmDCrL 和 MTang 模式的使用提高了对负荷和间隙形成的抵抗力，与 3LP 相比，在健康犬肌腱修复中具有更好的生物力学性能。
这些结果证明了在犬屈肌腱缝合中对 ExDCrL、EmDCrL 或 MTang 模式进行体内评估的合理性。
