Development of a new suturing technique for tendon graft preparation: an animal cadaver study.
BACKGROUND
This study should analyze ten different suturing techniques for tendon graft preparation to allow the development of an entirely new suturing technique.


METHODS
Extensor tendon grafts of fattening bulls' forelegs were sutured with Ethibond Excel size three (six metric) fibers (Ethicon, Somerville, New York, USA). The tendon/suture complexes were biomechanically tested with a hydraulic testing machine applying traction according to a standardized protocol. The testing was observed to find out why the failure at the maximum traction load occurred. The mean values for the maximum tension and extension stiffness were recorded for each suturing technique.


RESULTS
An entirely new suturing technique was developed based on the observations and biomechanical results. The newly developed suture was also tested and provided a higher traction stability than the other ten techniques that had been evaluated. Compared to the other ten techniques the new technique was ranked 3rd in terms of extension stiffness and reached 10.3 N/mm.


CONCLUSIONS
The new technique evolved in the course of this study provided promising results. Therefore this study provides initial evidence that this technique could be useful in clinical routine.
Department of Trauma Surgery, Klinikum rechts der Isar, Technische Universitaet Muenchen, Ismanninger Str. 22, 81675 Munich, Germany.
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Postl
Department of Trauma Surgery, Klinikum rechts der Isar, Technische Universitaet Muenchen, Ismanninger Str. 22, 81675 Munich, Germany.
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Kirchhoff
Department of Orthopedics, Biomechanics Laboratory, Munich University Hospital - Campus Großhadern, Ludwig-Maximilians Universitaet, Marchioninistr. 15, 81377 Munich, Germany.
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Hupertz
Department of Orthopedics, Biomechanics Laboratory, Munich University Hospital - Campus Großhadern, Ludwig-Maximilians Universitaet, Marchioninistr. 15, 81377 Munich, Germany.
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Plitz
Department of Orthopedics, Munich University Hospital - Campus Großhadern, Ludwig-Maximilians Universitaet, Marchioninistr. 15, 81377 Munich, Germany; Specialist Hospital for Orthopedics, Traumatology and Sports Medicine, Medical Park Chiemsee, Birkenallee 41, 83233 Bernau-Felden, Germany. Electronic address: M.Schmitt-Sody@medicalpark.de.
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Schmitt-Sody
D000818:Animals; D001696:Biomechanical Phenomena; D002102:Cadaver; D002417:Cattle; D004195:Disease Models, Animal; D008297:Male; D011093:Polyethylene Terephthalates; D019651:Plastic Surgery Procedures / Q000379:methods*; D013314:Stress, Mechanical; D013536:Suture Techniques; D013537:Sutures / Q000592:standards*; D013710:Tendons / Q000601:surgery* / Q000637:transplantation
C014534:Ethibond; D011093:Polyethylene Terephthalates
Biomechanics; Geometrical alteration; New suturing technique; Suture