Ex-vivo evaluation of a modified Teno Fix® device repair pattern versus a 3-loop pulley for repair of equine flexor tendons

Objective: To compare the load to ultimate failure, load to a 2 mm gap, mode of failure, and gap at failure (mm) of the Teno Fix® (TF) to the 3‐loop pulley (3LP) for repair of equine tendon lacerations. The use of 4TF devices versus 5TF devices on load to ultimate failure and load to a 2 mm gap was also compared. Study Design: Ex vivo biomechanical study; unbalanced incomplete block (horse) design. Samples: Cadaveric equine forelimb superficial digital flexor tendon (n = 20 paired tendons). Methods: Ten tendon pairs were selected randomly and repaired with a 3LP and 4TF pattern, and 10 tendon pairs repaired with a 3LP and 5TF pattern. Load to ultimate failure, load to a 2 mm gap, mode of failure, and gap at failure were obtained using materials testing. Results: The 3LP had a significantly greater ultimate load to failure (P < .001, respectively) and a significantly higher load to a 2 mm gap than both TF repairs (P < .001, respectively). The most frequent mode of failure was suture pull‐out for the 3LP and anchor pull‐out for the TF. Gap at failure was significantly larger in the 3LP than both TF repairs (P < .001). The ultimate load to failure was significantly higher for the 5TF than the 4TF (P = .004) but there was no significant difference in load to a 2 mm gap, or gap at failure between both TF repairs (P = .11, P = .15, respectively). Conclusions: Neither TF repair was stronger than the 3LP in load to ultimate failure and load to a 2 mm gap. Addition of a fifth TF device significantly increased the load to ultimate failure but did effect the load to a 2 mm gap over the 4TF

Evaluation of the in vitro performance of the double forwarder knot, compared to square and surgeon's knots using large gauge suture.

ObjectiveThe aim of the study was to evaluate the strength and size of the double forwarder (DF) knot in 2 and 3 USP polyglactin 910 when used to form a ligature and to compare the knot holding capacity (KHC), size and weight of the DF knot to surgeon's (SU) and square (SQ) knots with varying numbers of throws.Study designLaboratory study.Study populationKnotted suture.MethodsKnots were tied using 2 and 3 USP polyglactin 910 and tested on a universal testing machine under linear tension. Mode of failure and (KHC) were recorded. Knot volume and weight were determined by digital micrometer and balance. KHC, size, and weight between knot type, number of throws, and suture type and size were compared using ANOVA testing, with p ResultsIn both suture types, DF knots had a higher KHC than SQ/SU knots (p  .42). All DF knots failed by suture breakage at the knot, as did all SQ/SU knots with >6 throws. DF knots in 2 and 3 USP polyglactin 910 were larger and heavier than SQ and SU knots when the same number of throws was applied (p ConclusionSelf-locking DF knots provided increased strength compared to SU/SQ in large gauge suture but only when fewer than six throws are applied to SU/SQ knots.Clinical relevanceThe new DF knot could be an alternative for a secure ligature