Comparison of 1- and 2-knot, 4-strand, double-modified kessler tendon repairs in a porcine model.
OBJECTIVE
To compare 1- and 2-knot, 4-strand, double-modified Kessler tendon repairs. It was our hypothesis that a 1-knot technique using an unbraided suture material would be stronger if it is possible for some movement to occur between strands on loading, redistributing forces such that the load is equally shared.


METHODS
Fifty-six porcine flexor tendons were allocated to either a 1- or 2-knot, 4-strand, double-modified Kessler repair, and tested by incremental cyclical loading in vitro.


RESULTS
The 1-knot technique was significantly stronger. Gap formation was initially greater in the 1-knot group, consistent with movement of strands, but with increasing physiological levels of applied force, there was no significant difference between the groups.


CONCLUSIONS
The 1-knot technique was significantly stronger than the 2-knot technique.
Department of Plastic and Reconstructive Surgery, Norfolk and Norwich University Hospital, Norwich, Norfolk, UK. leilarees24@hotmail.com
Leila
L
Rees
April
A
Matthews
Spyridon D
SD
Masouros
Anthony M J
AM
Bull
Richard
R
Haywood
D000818:Animals; D001696:Biomechanical Phenomena; D011183:Postoperative Complications / Q000503:physiopathology*; D012421:Rupture; D013536:Suture Techniques; D013552:Swine; D013708:Tendon Injuries / Q000601:surgery*; D053656:Tenodesis / Q000379:methods*; D013718:Tensile Strength / Q000502:physiology; D016474:Weight-Bearing / Q000502:physiology*