RT Journal Article
ID 1eafeccb44116458
A1 Mait, Jeffrey E.
A1 Hayes, Westley T.
A1 Blum, Christopher L.
A1 Pivec, Robert
A1 Zaino, Christian J.
A1 Jauregui, Julio J.
A1 Saha, Subrata
A1 Uribe, Jaime A.
A1 Urban, William P.
T1 A Biomechanical Comparison of Different Tendon Repair Techniques
JF Journal of Long-Term Effects of Medical Implants
JO JLT
YR 2016
FD 2017-01-06
VO 26
IS 2
SP 167
OP 171
K1 suture
K1 Krackow technique
K1 tendon
K1 suture strength
K1 Krackow/Bunnell
K1 suture
AB Previous studies have examined multiple suture techniques for the repair of ruptured tendons. In this study, we investigated how the two- and four-stranded Krackow suture weave techniques compared with a novel Krackow/Bunnell suture technique. Our hypothesis was that the Krackow/Bunnell suture would have greater strength compared with the two- and four-stranded Krackow suture in terms of resistance to pullout from the muscle tendon. Thirty fresh bovine Achilles tendons were assigned randomly to three groups: (1) two-stranded Krackow, (2) fourstranded Krackow, and (3) the Krackow/Bunnell combination. After suture placement, all specimens were subjected to initial cyclic loading (0–200 N for 200 cycles) and then the tension to failure force defined as the pullout through the muscle tendon was evaluated. Significantly greater deformation before suture failure was seen in the Krackow/Bunnell group compared with the four-stranded Krackow construct (36.2 vs. 28.7 mm, p = 0.009), as well as greater energy required to rupture the suture (4635 vs. 3346 N/mm; p = 0.016). There was no significant difference with regard to the force to failure between the two groups (four-stranded Krackow vs. Krackow/Bunnell). The two-stranded Krackow was found to be inferior to both the four-stranded Krakow and the Krakow/Bunnell techniques with regard to load to failure. We have found that the Krackow/Bunnell suture technique is at least comparable to, if not superior to, the four-stranded Krackow technique with regard to deformation before suture failure and energy required to rupture the
tendon. Therefore, the Krackow/Bunnell technique may be an optimal construct if the surgeon is concerned about
suture pullout through the tendon; however, future studies evaluating this technique in the clinical setting are required
before making any final conclusions for patient use.
PB Begell House
LK https://www.dl.begellhouse.com/journals/1bef42082d7a0fdf,7b6ba9c258e2ab07,1eafeccb44116458.html