title: Asymmetric six-strand core sutures enhance tendon fatigue strength and the optimal asymmetry.
abstract: Under cyclic loading, we recorded the fatigue strength of a six-strand tendon repair with different symmetry in the lengths of suture purchase in two stumps of 120 dental rolls and in 30 porcine tendons. First, the strengths of the repairs with 1, 2, 3, 4 and 5 mm asymmetry were screened using the dental rolls. The asymmetric core suture repairs were then made with a Kessler repair of equal suture purchase (10 mm) in two tendon stumps, and shifting two other Kessler repairs by 1, 3 or 5 mm, respectively, along the longitudinal axis of the tendon in relation to the first (symmetric) Kessler repair. The core repairs with 3 mm or more asymmetry in suture purchases in two tendon ends showed significantly greater fatigue strength and significantly smaller gaps compared with 1 mm asymmetry in core suture repair. Our results support that asymmetric placement of core sutures in two tendon ends favour resisting gapping at the repair site and 3 mm or more asymmetry is needed to produce such beneficial effects.
authors.affiliation: Department of Orthopaedic Surgery, Kyushu University, Fukuoka, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Kozono
authors.affiliation: Department of Orthopaedic Surgery, Kyushu University, Fukuoka, Japan t-okada@ortho.med.kyushu-u.ac.jp.
authors.forename: T
authors.initials: T
authors.lastname: Okada
authors.affiliation: Department of Orthopaedic Surgery, Kyushu University, Fukuoka, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Takeuchi
authors.affiliation: Department of Orthopaedic Surgery, Kyushu University, Fukuoka, Japan Department of Plastic Surgery, Kyushu University, Fukuoka, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Hanada
authors.affiliation: Department of Information and System Engineering, Fukuoka Institute of Technology, Fukuoka, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Shimoto
authors.affiliation: Department of Orthopaedic Surgery, Kyushu University, Fukuoka, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Iwamoto
mesh_terms: D000818:Animals; D032561:Cotton Fiber; D003742:Dental Devices, Home Care; D005383:Finger Injuries / Q000601:surgery*; D006801:Humans; D011126:Polypropylenes; D013536:Suture Techniques; D013537:Sutures; D013552:Swine; D013708:Tendon Injuries / Q000601:surgery*; D013718:Tensile Strength; D014935:Wool
chemical_list: D011126:Polypropylenes
keywords: Six-strand core suture; cyclic loading; fatigue strength; flexor tendon repair