AAPS
Twitter YouTube LinkedIn
2008 Annual Meeting Abstracts

Back to 87th Annual Meeting
Back to Program Outline


Barbed Suture Tenorrhaphy: An Ex-Vivo Biomechanical Analysis
Pranay M. Parikh, MD1, Steven P. Davison, DDS, MD1, James P. Higgins, MD2.
1Georgetown University Hospital, Washington, DC, USA, 2Curtis National Hand Center, Baltimore, MD, USA.

PURPOSE: Maximizing the strength of flexor tendon repair techniques allows earlier postoperative rehabilitation and improved functional results. The tensile strength of currently used repair techniques is defined by the force required for suture pullout or knot rupture. Use of a barbed suture for flexor tenorrhaphy could permit knotless repair with tendon barb adherence along the suture's entire length. The purpose of this study is to evaluate the tensile strength of a novel technique for flexor tendon repair employing barbed suture.
METHODS: Forty cadaveric FDP tendons were lacerated in zone 2 and randomized to a novel barbed 2-0 polypropylene repair in a knotless 3 core or 6 core configuration, or to traditional 4 core cruciate repair with either 4-0 polypropylene, 4-0 braided nylon, or 4-0 fiberwire. For each repair we recorded the ratio of the cross sectional area at the repair site to that of the native tendon. Tendons were then linearly distracted to failure, and the load at failure and mode of failure were recorded. One-way ANOVA and chi-squared tests were used to determine significant differences between groups.
RESULTS: The mean cross sectional area ratio of control 4 core cruciate repairs was 1.56 +/- 0.30cm2, while those of 3 core and 6 core barbed repairs were 1.16 +/- 0.25cm2 (p < 0.02) and 1.25 +/- 0.14cm2 (p < 0.02), respectively. The mean load to failure of control repairs was 32.8 +/- 9.8N, while those of 3 core and 6 core barbed repairs were 39.0 +/- 3.7N (p = 0.62) and 88.3 +/- 3.6N (p < 0.001), respectively. Cruciate repairs failed by suture pullout in 5/24 tendons whereas barbed repairs failed by suture pullout in 1/16 repairs (p = 0.37).
CONCLUSION: In an ex-vivo model of flexor tendon repair, a 3 core barbed suture technique achieved tensile strength comparable to that of traditional 4 core cruciate repairs, while demonstrating significantly less repair site bunching. A 6 core barbed suture technique demonstrated markedly increased tensile strength compared to 4 core cruciate controls, as well as significantly less repair site bunching. Our data suggests that barbed suture repair may offer several advantages in flexor tenorrhaphy, and that further in-vivo testing is warranted.


Back to 87th Annual Meeting
Back to Program Outline

Quick Links
About
Membership
Annual Meeting
Awards
Publications
Pledge
 
Twitter YouTube LinkedIn