title: Effect of suture knot location on tensile strength after flexor tendon repair.
abstract: This study investigated the effect of increased suture material within the flexor tendon repair site on tensile strength in a canine model after in vivo healing. Four-strand modified Savage suture repairs with the knots located either inside or outside the repair site were performed in dogs. The tendons were placed on a passive-motion protocol after surgery and were biomechanically tested at 1, 3, and 6 weeks of in vivo healing. The knots-outside technique initially was 1.14 kg stronger on load-to-failure testing. After 6 weeks of healing, the knots-inside tendons had equal tensile strength (3.91 +/- 0.50 kg [inside] vs 4.16 +/- 0.66 kg [outside]). Relative tensile strength compared to initial strength showed an increase of 20% for the knots-outside technique and an increase of 67% for the knots-inside technique after 6 weeks. Suture material within the repair site did not have any deleterious effects on tensile strength and may stimulate tendon healing.
authors.affiliation: Department of Orthopedic Surgery, Washington University Medical School, St. Louis, MO, USA.
authors.forename: D L
authors.initials: DL
authors.lastname: Pruitt
authors.forename: M
authors.initials: M
authors.lastname: Aoki
authors.forename: P R
authors.initials: PR
authors.lastname: Manske
mesh_terms: D000818:Animals; D004285:Dogs; D066298:In Vitro Techniques; D013536:Suture Techniques; D013537:Sutures; D013710:Tendons / Q000502:physiology* / Q000601:surgery*; D013718:Tensile Strength; D013997:Time Factors