scholarly journals In vitro Biomechanical Study of Pulvertaft Tendon Weaving Technique

2011 ◽  
Vol 15 (2) ◽  
pp. 62-64 ◽  
Author(s):  
Yuen Chi-Pan ◽  
Yen Chi-Hung ◽  
Leung Hon-Bong ◽  
Tse Wing-Lim ◽  
Ho Pak-Cheong ◽  
...  
Keyword(s):  
Peak Load ◽  
Tendon Repair ◽  
Early Mobilization ◽  
Biomechanical Properties ◽  
Biomechanical Study ◽  
Load To Failure ◽  
Active Mobilization ◽  
Passive Mobilization ◽  
Single Suture

Background/Purposes The outcome of tendon repair depends on the strength, which allows early active mobilization to achieve better function without rupture. The aims of this study are to assess quantitatively the biomechanical properties and relationship between the number of tendon weaving and suture method using Pulvertaft technique. Results We found that the load to failure was increased with increasing number of weaves and sutures. From 1-weave to 4-weave single suture samples, the peak load to failure was 9.5 N, 19.7 N, 37.5 N, and 42.6 N, respectively. Based on previous studies, wrist and finger tendons should withstand 1–8N on passive mobilization. Conclusion On active mobilization, finger tendon repair need to provide 34 N for immediate mobilization. Therefore, irrespective of number of sutures, both 3- and 4-weave repairs could allow early mobilization biomechanically.

An In Vitro Biomechanical Study Comparing the Spiral Linking Technique Against the Pulvertaft Weave for Tendon Repair

2007 ◽  
Vol 32 (4) ◽  
pp. 377-381 ◽  
Author(s):  
Y. I. KULIKOV ◽  
S. DODD ◽  
S. GHEDUZZI ◽  
A. W. MILES ◽  
G. E. B. GIDDINS
Keyword(s):  
Testing Machine ◽  
Peak Load ◽  
Tendon Repair ◽  
Tensile Loading ◽  
Biomechanical Study ◽  
The Other ◽  
Instron Testing Machine ◽  
Peak Loads ◽  
The Mean

A new spiral linking technique for tendon repair in which one end of the tendon is spiralled around the other end has been developed. Using pig trotter extensor tendons, the Pulvertaft weave technique was compared with this new technique. Twenty-five repairs using each technique were tested by tensile loading with an Instron testing machine. The spiral linking technique matched the strength of Pulvertaft method: the mean peak loads were 102 and 105 N, respectively. The Pulvertaft weave was stiffer than the spiral linking technique: mean stiffness of 11.1 and 6.7 N/mm, respectively. The spiral linking technique also absorbed considerably more energy: energy absorbed prior to failure to 90% of peak load, 1.75 and 1.13 kN mm, respectively. In conclusion, the spiral linking technique appears as strong as the Pulvertaft weave and we believe it is easier to perform.

Augmentation of Distal Biceps Repair With an Acellular Dermal Graft Restores Native Biomechanical Properties in a Tendon-Deficient Model

2017 ◽  
Vol 45 (9) ◽  
pp. 2028-2033 ◽  
Author(s):  
Christine Conroy ◽  
Paul Sethi ◽  
Craig Macken ◽  
David Wei ◽  
Marc Kowalsky ◽  
...  
Keyword(s):  
Biceps Tendon ◽  
Peak Load ◽  
Tendon Repair ◽  
Biomechanical Properties ◽  
Gap Formation ◽  
Dermal Graft ◽  
Distal Biceps ◽  
Load To Failure ◽  
The Mean ◽  
Acellular Dermal

Background: The majority of distal biceps tendon injuries can be repaired in a single procedure. In contrast, complete chronic tears with severe tendon substance deficiency and retraction often require tendon graft augmentation. In cases with extensive partial tears of the distal biceps, a human dermal allograft may be used as an alternative to restore tendon thickness and biomechanical integrity. Hypothesis: Dermal graft augmentation will improve load to failure compared with nonaugmented repair in a tendon-deficient model. Study Design: Controlled laboratory study. Methods: Thirty-six matched specimens were organized into 1 of 4 groups: native tendon, native tendon with dermal graft augmentation, tendon with an attritional defect, and tendon with an attritional defect repaired with a graft. To mimic a chronic attritional biceps lesion, a defect was created by a complete tear, leaving 30% of the tendon’s width intact. The repair technique in all groups consisted of cortical button and interference screw fixation. All specimens underwent cyclical loading for 3000 cycles and were then tested to failure; gap formation and peak load at failure were documented. Results: The mean (±SD) load to failure (320.9 ± 49.1 N vs 348.8 ± 77.6 N, respectively; P = .38) and gap formation (displacement) (1.8 ± 1.4 mm vs 1.6 ± 1.1 mm, respectively; P = .38) did not differ between the native tendon groups with and without graft augmentation. In the tendon-deficient model, the mean load to failure was significantly improved with graft augmentation compared with no graft augmentation (282.1 ± 83.8 N vs 199.7 ± 45.5 N, respectively; P = .04), while the mean gap formation was significantly reduced (1.2 ± 1.0 mm vs 2.7 ± 1.4 mm, respectively; P = .04). The mean load to failure of the deficient tendon with graft augmentation (282.1 N) compared with the native tendon (348.8 N) was not significantly different ( P = .12). This indicates that the native tendon did not perform differently from the grafted deficient tendon. Conclusion: In a tendon-deficient, complete distal biceps rupture model, acellular dermal allograft augmentation restored the native tendon’s biomechanical properties at time zero. The grafted tissue-deficient model demonstrated no significant differences in the load to failure and gap formation compared with the native tendon. As expected, dermal augmentation of attritional tendon repair increased the load to failure and stiffness as well as decreased displacement compared with the ungrafted tissue-deficient model. Tendons with their native width showed no statistical difference or negative biomechanical consequences of dermal augmentation. Clinical Relevance: Dermal augmentation of the distal biceps is a biomechanically feasible option for patients with an attritionally thinned-out tendon.

scholarly journals Hypoxia-Induced Mesenchymal Stem Cells Exhibit Stronger Tenogenic Differentiation Capacities and Promote Patellar Tendon Repair in Rabbits

2020 ◽  
Vol 2020 ◽  
pp. 1-16
Author(s):  
Guanyin Chen ◽  
Wangqian Zhang ◽  
Kuo Zhang ◽  
Shuning Wang ◽  
Yuan Gao ◽  
...  
Keyword(s):  
Patellar Tendon ◽  
Tendon Repair ◽  
Biomechanical Properties ◽  
Clinical Results ◽  
Medical Problem ◽  
Tendon Injury ◽  
Tenogenic Differentiation ◽  
Tgf Β1

Tendon injury is a common but tough medical problem. Unsatisfactory clinical results have been reported in tendon repair using mesenchymal stem cell (MSC) therapy, creating a need for a better strategy to induce MSCs to tenogenic differentiation. This study was designed to examine the effect of hypoxia on the tenogenic differentiation of different MSCs and their tenogenic differentiation capacities under hypoxia condition in vitro and to investigate the in vivo inductility of hypoxia in tenogenesis. Adipose tissue-derived MSCs (AMSCs) and bone marrow-derived MSCs (BMSCs) were isolated and characterized. The expression of hypoxia-induced factor-1 alpha (Hif-1α) was examined to confirm the establishment of hypoxia condition. qRT-PCR, western blot, and immunofluorescence staining were used to evaluate the expression of tendon-associated marker Col-1a1, Col-3a1, Dcn, and Tnmd in AMSCs and BMSCs under hypoxia condition, compared with Tgf-β1 induction. In vivo, a patellar tendon injury model was established. Normoxic and hypoxic BMSCs were cultured and implanted. Histological, biomechanical, and transmission electron microscopy analyses were performed to assess the improved healing effect of hypoxic BMSCs on tendon injury. Our in vitro results showed that hypoxia remarkably increased the expression of Hif-1α and that hypoxia not only promoted a significant increase in tenogenic markers in both AMSCs and BMSCs compared with the normoxia group but also showed higher inductility compared with Tgf-β1. In addition, hypoxic BMSCs exhibited higher potential of tenogenic differentiation than hypoxic AMSCs. Our in vivo results demonstrated that hypoxic BMSCs possessed better histological and biomechanical properties than normoxic BMSCs, as evidenced by histological scores, patellar tendon biomechanical parameters, and the range and average of collagen fibril diameters. These findings suggested that hypoxia may be a practical and reliable strategy to induce tenogenic differentiation of BMSCs for tendon repair and could enhance the effectiveness of MSCs therapy in treating tendon injury.

Finger zone II flexor tendon repair in children (5–10 years of age) using three ‘figure of eight’ sutures followed by immediate active mobilization

2011 ◽  
Vol 36 (4) ◽  
pp. 291-296 ◽  
Author(s):  
Mohammad M. Al-Qattan
Keyword(s):  
Flexor Tendon ◽  
Tendon Repair ◽  
Early Mobilization ◽  
Final Outcome ◽  
Study Group ◽  
Flexor Tendon Repair ◽  
Active Mobilization ◽  
Zone Ii ◽  
Adult Rehabilitation

For children between 5–10 years of age with zone II flexor tendon lacerations, the literature recommends a modified early mobilization programme under the supervision of a hand therapist but the fingers are immobilized between physiotherapy sessions. We report on a series of children between 5–10 years of age with flexor tendon lacerations (n = 54 fingers) in zone II repaired with a six-strand core suture (three separate ‘figure of eight’ sutures) and actively mobilized immediately after surgery similar to adult rehabilitation programmes with no immobilization between the physiotherapy sessions. The average follow-up for the study group was 13 months (range 7–25 months). There were no ruptures. The final outcome was excellent in 46 fingers (85%) and good in the remaining eight fingers (15%) using the Strickland–Glogovac criteria.

scholarly journals A Novel Fixation System for Acetabular Quadrilateral Plate Fracture: A Comparative Biomechanical Study

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Guo-Chun Zha ◽  
Jun-Ying Sun ◽  
Sheng-Jie Dong ◽  
Wen Zhang ◽  
Zong-Ping Luo
Keyword(s):  
Plate Fixation ◽  
Biomechanical Properties ◽  
Biomechanical Study ◽  
Pelvic Brim ◽  
Quadrilateral Plate ◽  
Plate Fracture ◽  
Fixation Techniques ◽  
Biomechanical Experiment ◽  
Fixation System

This study aims to assess the biomechanical properties of a novel fixation system (named AFRIF) and to compare it with other five different fixation techniques for quadrilateral plate fractures. This in vitro biomechanical experiment has shown that the multidirectional titanium fixation (MTF) and pelvic brim long screws fixation (PBSF) provided the strongest fixation for quadrilateral plate fracture; the better biomechanical performance of the AFRIF compared with the T-shaped plate fixation (TPF), L-shaped plate fixation (LPF), and H-shaped plate fixation (HPF); AFRIF gives reasonable stability of treatment for quadrilateral plate fracture and may offer a better solution for comminuted quadrilateral plate fractures or free floating medial wall fracture and be reliable in preventing protrusion of femoral head.

Achilles tendon repair: Achillon system vs. Krackow suture: An anatomic in vitro biomechanical study

2008 ◽  
Vol 23 (9) ◽  
pp. 1158-1164 ◽  
Author(s):  
B. Huffard ◽  
P.F. O’Loughlin ◽  
T. Wright ◽  
J. Deland ◽  
J.G. Kennedy
Keyword(s):  
Achilles Tendon ◽  
Tendon Repair ◽  
Biomechanical Study ◽  
Achilles Tendon Repair ◽  
Krackow Suture

Comparative Evaluation of Bone Suture Anchor to Bone Tunnel Fixation of Tibialis Anterior Tendon in Cadaveric Cuboid Bone: A Biomechanical Investigation

1995 ◽  
Vol 16 (10) ◽  
pp. 641-645 ◽  
Author(s):  
Colin W. Fennell ◽  
John M. Ballard ◽  
Daniel S. Pflaster ◽  
Rodney H. Adkins
Keyword(s):  
Tibialis Anterior ◽  
Suture Anchor ◽  
Biomechanical Study ◽  
Bone Tunnel ◽  
Biomechanical Analysis ◽  
Tibialis Anterior Tendon ◽  
Cuboid Bone ◽  
Load To Failure ◽  
Bone Tunnels

A multiphase biomechanical study was performed using human tibialis anterior tendons and cuboid bones, comparing the fixation of the tendon to the bone using bone anchors and bone tunnels. Twenty-six specimens were tested for ultimate load to failure comparing Mitek Superanchor fixation with no. 1 and no. 5 braided polyethelyne suture to bone tunnel fixation. Mitek Superanchor with no. 5 suture failed at 223 N, compared with Mitek Superanchor with no. 1 suture at 134 N and bone tunnel at 143 N ( P = 0.033). Mitek with no. 1 suture versus bone tunnel was not significantly different. The Mitek with no. 5 suture failed at the tendon/suture interface (75%), the Mitek with no. 1 suture failed at the suture/anchor interface (56%), and bone tunnel fixation failed most commonly by fracture of the tunnel (76%). This study is the first biomechanical analysis of the pullout strengths of bone tunnels or suture anchors in the cuboid bone. We have shown that the suture anchor has a pullout strength comparable or superior to a conventional bone tunnel in an in vitro situation. We believe it is a viable alternative to fixation of the tibialis anterior tendon to the cuboid when there is insufficient tendon length or failure of the bone tunnel.

Flexor tendon repair using a new suture technique: a comparative in vitro biomechanical study

2010 ◽  
Vol 37 (1) ◽  
pp. 79-84 ◽  
Author(s):  
M. Schädel-Höpfner ◽  
J. Windolf ◽  
T. T. Lögters ◽  
M. Hakimi ◽  
I. Celik
Keyword(s):  
Flexor Tendon ◽  
Tendon Repair ◽  
Suture Technique ◽  
Biomechanical Study ◽  
Flexor Tendon Repair

Biomechanical investigation of ‘figure of 8’ flexor tendon repair techniques

2016 ◽  
Vol 41 (8) ◽  
pp. 815-821 ◽  
Author(s):  
A. K. Agrawal ◽  
I. S. Mat Jais ◽  
E. M. Chew ◽  
A. K. T. Yam ◽  
S. C. Tay
Keyword(s):  
Tendon Repair ◽  
Biomechanical Study ◽  
Flexor Digitorum Profundus ◽  
Modified Technique ◽  
Flexor Tendon Repair ◽  
Group 4 ◽  
Biomechanical Investigation ◽  
Active Mobilization ◽  
Flexor Digitorum ◽  
Repair Techniques

This biomechanical study compared the original Al-Qattan repair with other modifications postulated to reduce bulk and friction, thereby potentially improving outcome. A total of 32 cadaveric digits with intact flexor apparatus were used. In each digit, the flexor digitorum profundus and flexor digitorum superficialis tendons were cut cleanly in Zone 2. We tested Al-Qattan’s technique along with three modifications using stronger suture material and varying the number of strands across the repair site. Of the four repair techniques, the modified Al-Qattan’s technique using two ‘figure of 8’ 4-0 Fiberwire core sutures (Group 4) had the best balance of ultimate tensile strength (50.9 N), 2 mm gapping force (38 N) and friction. The modified technique provided a stronger repair for early active mobilization and has less friction than the originally described repair.

Comparative Study of Biomechanical Properties between Needled Suture and Needleless Suture in Multi-Strand Tendon Graft Model

2021 ◽  
Vol 104 (9) ◽  
pp. 1447-1451
Keyword(s):  
Testing Machine ◽  
Biomechanical Properties ◽  
Tendon Graft ◽  
Suture Technique ◽  
Biomechanical Study ◽  
Modes Of Failure ◽  
Tendon Elongation ◽  
Significant Difference ◽  
Load To Failure ◽  
Distraction Force

Objective: To compare the biomechanical properties of the Chinese finger (CF) suture, a needleless suture technique, with the baseball stitch (BS) suture, a needled suture technique, in a multi-strand model by using a 4-strand tendon model. Additionally, the BS was compared with the serial rolling hitch (RH), a locking needleless suture technique. Materials and Methods: 4-strand grafts, made from two 20-cm fresh porcine toe extensors, were used in all three groups. After the grafts were sutured, pretension was applied with a load of 100-N distraction force for five minutes. After the tendon elongation was measured before and after the pretension, the distraction force was continued until the constructed graft failed. Stress-strain relationship graphs were recorded by universal testing machine (UTM), distributing to the calculation of percentage on tendon elongation, stiffness, and load-to-failure. Results: The BS had significantly higher load of failure than the CF (p=0.001) but no significant difference when compared with the RH. Comparing between BS, CF, and RH, there were no significant difference in stiffness and percentage of tendon elongation. In modes of failure, there was evidence of knot slipping in CF in six of six cases and graft strangulation in RH in four of six cases. Conclusion: Multi-strand model BS, a needled suture, had a higher load to failure than CF, a needleless suture. Moreover, needleless sutures had serious modes of failure, which were knot slipping and strangulation of graft by the suture material. Therefore, needleless suture technique for multi-strand tendon graft preparation was not recommended. Keywords: Tendon preparation; Multi-Strand; Needled suture; Needleless suture; Chinese finger; Baseball stitch; Rolling Hitch; Biomechanical study; Graft elongation; Load to failure

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