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A knotless bidirectional-barbed tendon repair is inferior to conventional 4-strand repairs in cyclic loading.

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Citation: Journal of Hand Surgery: European Volume. 41(8):809-14, 2016 OctPMID: 26936746Institution: Curtis National Hand CenterForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Finger Injuries/su [Surgery] | *Suture Techniques | *Sutures | *Tendon Injuries/su [Surgery] | *Tensile Strength | Cadaver | Humans | Range of Motion, ArticularYear: 2016 ISSN:

0266-7681

Name of journal: The Journal of hand surgery, European volumeAbstract: Copyright (c) The Author(s) 2016.LEVEL OF EVIDENCE: Level V.We divided 21 flexor digitorum profundus tendons in the index, middle and ring fingers in seven cadaver hands into three groups. The tendons were cut in zone 2 and repaired using a 4-strand cruciate core suture repair with one of the following three materials in each group: (1) a knotless repair with a 2-0 bidirectional-barbed suture, which has similar tensile strength as a 4-0 non-barbed suture used in the other two groups; (2) a knotted locking repair with a non-barbed 4-0 conventional suture; and (3) a non-locking repair with a non-barbed 4-0 knotless suture. The repaired fingers were cyclically loaded through a simulated active range of motion to a 5N load. We monitored and recorded the gap sizes at regular intervals during the test. The 2-0 bidirectional-barbed suture group and non-barbed suture groups developed gaps of 2.2mm after 10 cycles and 2.4mm after 20 cycles, respectively. Over 1000 cycles, the mean gaps were 3.2mm in the 4-0 conventional suture group and 9.1mm in the 2-0 bidirectional-barbed group. The tendons in the 2-0 bidirectional-barbed group gapped earlier, with statistically significant differences compared with those in the locking repair with a non-barbed 4-0 knotless suture group. The repair strength of the barbed suture technique was inferior to the cruciate repairs using a conventional 4-0 non-barbed suture tested in this cyclic-loading model.All authors: Means KR Jr, O'Brien FP 3rd, Parks BG, Tsai MAFiscal year: FY2017Digital Object Identifier:

https://dx.doi.org/10.1177/1753193416631440

Date added to catalog: 2017-12-13

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Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	26936746	Available		26936746

LEVEL OF EVIDENCE: Level V.

We divided 21 flexor digitorum profundus tendons in the index, middle and ring fingers in seven cadaver hands into three groups. The tendons were cut in zone 2 and repaired using a 4-strand cruciate core suture repair with one of the following three materials in each group: (1) a knotless repair with a 2-0 bidirectional-barbed suture, which has similar tensile strength as a 4-0 non-barbed suture used in the other two groups; (2) a knotted locking repair with a non-barbed 4-0 conventional suture; and (3) a non-locking repair with a non-barbed 4-0 knotless suture. The repaired fingers were cyclically loaded through a simulated active range of motion to a 5N load. We monitored and recorded the gap sizes at regular intervals during the test. The 2-0 bidirectional-barbed suture group and non-barbed suture groups developed gaps of 2.2mm after 10 cycles and 2.4mm after 20 cycles, respectively. Over 1000 cycles, the mean gaps were 3.2mm in the 4-0 conventional suture group and 9.1mm in the 2-0 bidirectional-barbed group. The tendons in the 2-0 bidirectional-barbed group gapped earlier, with statistically significant differences compared with those in the locking repair with a non-barbed 4-0 knotless suture group. The repair strength of the barbed suture technique was inferior to the cruciate repairs using a conventional 4-0 non-barbed suture tested in this cyclic-loading model.

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