title: The three-loop pulley suture versus two locking-loop sutures for the repair of canine achilles tendons.
abstract: OBJECTIVE
  To compare a 3-loop pulley suture pattern with 2 locking-loop sutures for the repair of components of the canine Achilles mechanism.
  
  
  METHODS
  In vitro biomechanical study.
  
  
  METHODS
  Forty-eight paired tendons collected from 9 canine cadavers.
  
  
  METHODS
  Paired tendons were repaired with either a 3-loop pulley suture or 2 locking-loop sutures and tensile tested to failure. To ensure accurate anastomosis gap measurement a direct, non-contact, method of gap measurement, using digital video, was devised. Load initiating gap formation (defined as load at a 1 mm gap) and load producing a 3 mm gap were evaluated in addition to maximum load, gap at failure, mode of failure, and time spent placing the sutures.
  
  
  RESULTS
  Maximum load values were similar for both repairs. The mean 1 mm gap loads were 44.0 and 18.4 N, and the mean 3 mm gap loads were 56.3 and 34.7 N, for the 3-loop pulley pattern and the 2 locking-loops, respectively; these differences were statistically significant. The 3-loop pulley pattern was faster to place and resulted in a smaller gap at failure. All but 2 repairs failed by suture pull out.
  
  
  CONCLUSIONS
  The 3-loop pulley pattern is more resistant to gap formation during tensile loading, and is quicker to place, than 2 locking-loop sutures.
  
  
  CONCLUSIONS
  Gap formation can significantly delay tendon healing. Tendon repairs with a gap >3 mm are reported to be at increased risk of rupture during the first 6 weeks postoperatively.
authors.affiliation: Department of Clinical Veterinary Science, University of Bristol, Langford House, Langford, Bristol, UK. andy.moores@bristol.ac.uk
authors.forename: Andy P
authors.initials: AP
authors.lastname: Moores
authors.forename: Martin R
authors.initials: MR
authors.lastname: Owen
authors.forename: John F
authors.initials: JF
authors.lastname: Tarlton
mesh_terms: D000125:Achilles Tendon / Q000293:injuries* / Q000601:surgery; D000818:Animals; D001696:Biomechanical Phenomena; D004285:Dogs / Q000293:injuries* / Q000601:surgery; D013536:Suture Techniques / Q000662:veterinary*; D013708:Tendon Injuries / Q000601:surgery / Q000662:veterinary*