title: The Interlocking Modification of the Cross Locked Cruciate Tendon Repair (Modified Adelaide Repair): A Static and Dynamic Biomechanical Assessment.
abstract: The 4-strand cross-locked cruciate flexor tendon repair technique (Adelaide technique) has been shown to have comparably high resistance to gap formation and ultimate tensile strength. This study aimed to determine whether an interlocking modification to the Adelaide repair would impart improved biomechanical characteristics. Twenty four sheep flexor tendons were harvested, transected and repaired using either standard or modified Adelaide techniques. Repaired tendons were cyclically loaded. Gap formation and ultimate tensile strength were measured. Additionally, suture exposure on the tendon surface was determined. There was a statistically significant increase in resistance to gap formation in the early phase of cyclic loading within the modified Adelaide group. In the later stages of testing no significant difference could be noted. The average final load to failure in the modified group was higher than the standard group but this did not achieve statistical significance. Interlocking suture techniques in four strand tendon repair constructs can improve gapping behavior in the early phase of cyclic loading.
authors.affiliation: Kings College Hospital London, Denmark Hill, London, UK SE5 9RS.
authors.forename: Ramon
authors.initials: R
authors.lastname: Tahmassebi
authors.affiliation: Surgical and Orthopaedic Research Laboratories, University of New South Wales, Prince of Wales Hospital, Sydney, Australia ; The Department of Hand Surgery, Sydney and St Lukes Hospital, Sydney, Australia.
authors.forename: Tim S
authors.initials: TS
authors.lastname: Peltz
authors.affiliation: Surgical and Orthopaedic Research Laboratories, University of New South Wales, Prince of Wales Hospital, Sydney, Australia ; The Department of Hand Surgery, Sydney and St Lukes Hospital, Sydney, Australia.
authors.forename: Roger
authors.initials: R
authors.lastname: Haddad
authors.affiliation: Surgical and Orthopaedic Research Laboratories, University of New South Wales, Prince of Wales Hospital, Sydney, Australia ; The Department of Hand Surgery, Sydney and St Lukes Hospital, Sydney, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Scougall
authors.affiliation: Surgical and Orthopaedic Research Laboratories, University of New South Wales, Prince of Wales Hospital, Sydney, Australia ; The Department of Hand Surgery, Sydney and St Lukes Hospital, Sydney, Australia.
authors.forename: Mark
authors.initials: M
authors.lastname: Gianoutsos
authors.affiliation: Surgical and Orthopaedic Research Laboratories, University of New South Wales, Prince of Wales Hospital, Sydney, Australia ; The Department of Hand Surgery, Sydney and St Lukes Hospital, Sydney, Australia.
authors.forename: William
authors.initials: W
authors.lastname: Walsh
keywords: Flexor tendon; Gap formation; Locking stitch; Tendon repair