Article
New developments in tendon repairs: The modified Adelaide repair and the knotless barbed suture tenorrhaphy – a biomechanical comparison
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Published: | September 27, 2011 |
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Introduction: Current literature suggests that the Adelaide Repair is not only stronger than other four-strand techniques, but also is a favorable repair in terms of gap formation. In this study we have modified the Adelaide suture configuration by interlocking its distal components. Additionally we introduce a new, potent tendon repair technique: The knotless barbed suture tenorrhaphy. Aim of this study was to compare these two new methods with the "gold standard" focusing not only on maximum load capacity but especially on gap formation.
Materials and methods: Deep flexor tendons were harvested from adult sheep forelimbs. Three groups were randomly divided and 12 repairs in each group were performed using different repair techniques: The (4-strand) “Adelaide” repair technique, the (4-strand) “Modified Adelaide” repair technique and a new (4-strand) barbed suture tendon repair technique. All repairs were performed by one surgeon using 3-0 braided polyester sutures (Ticron) for the “Adelaide” and “Modified Adelaide” repair group and a new polyglyconate 3-0 barbed suture (V-Loc) for the barbed suture repair group. No epitendinous repair was added. Cyclic (3N to 30N) and static tension loading was performed using a MTS Bionix machine. Repairs were analyzed at 10, 20, 30, 40, 50, 100, 150, 200 and 250 cycles. Thereafter, a tensile pull to failure was performed.
Results: Significant differences between the three tested groups could be shown regarding gapping and maximum load to failure (see figure). These results were independent to the size of the tendon or other factors.