Biomechanical study of a newly developed continuous double knots technique compared with the 4-strand double-modified Kessler technique for flexor tendon repair

Purpose In this study we compare the biomechanical properties of a novel suture technique that we developed called the continuous double knots technique for repairing flexor tendon injuries with the standard 4-strand double-modified Kessler technique. Methods This was an experimental study. Eighty porcine flexor digitorum profundus tendons were harvested and divided randomly into two groups of 40. The first group (N = 40) was repaired using the 4-strand double modified Kessler technique and the second group (N = 40) was repaired using our new continuous double knots technique. The two groups were randomly divided and the ultimate failure load (n = 20) and cyclic testing to failure (n = 20) were compared. Results The mean ultimate failure load was 25.90 ± 7.11 (N) and cyclic testing to failure 88 ± 47.87 (cycles) for the 4-strand double modified Kessler technique and 34.56 ± 6.60 (N) and 189 ± 66.36 (cycles) for our new continuous double knots technique. The T-test revealed a significant difference between the 2 techniques (p < 0.05). In terms of biomechanical properties in tendon repair, the continuous double knots technique group had a higher tensile strength than the 4-strand double-modified Kessler technique group. There were also significant differences between the ultimate failure load and cyclic testing to failure for the flexor tendon sutures. Conclusions The continuous double knots technique suture technique had significantly higher maximum tensile strength and cyclic testing than the 4-strand double modified Kessler technique in an in vitro study, and in thus an optional technique for flexor tendon repair.

Cyclic Deformation of Microcantilevers Using In-Situ Micromanipulation

Background The trend in miniaturisation of structural components and continuous development of more advanced crystal plasticity models point towards the need for understanding cyclic properties of engineering materials at the microscale. Though the technology of focused ion beam milling enables the preparation of micron-sized samples for mechanical testing using nanoindenters, much of the focus has been on monotonic testing since the limited 1D motion of nanoindenters imposes restrictions on both sample preparation and cyclic testing. Objective/Methods In this work, we present an approach for cyclic microcantilever bending using a micromanipulator setup having three degrees of freedom, thereby offering more flexibility. Results The method has been demonstrated and validated by cyclic bending of Alloy 718plus microcantilevers prepared on a bulk specimen. The experiments reveal that this method is reliable and produces results that are comparable to a nanoindenter setup. Conclusions Due to the flexibility of the method, it offers straightforward testing of cantilevers manufactured at arbitrary position on bulk samples with fully reversed plastic deformation. Specific microstructural features, e.g., selected orientations, grain boundaries, phase boundaries etc., can therefore be easily targeted.