Nineteen bovine Achilles tendons were repaired using a percutaneous/minimally invasive technique with a combination of a modified Bunnell suture proximally and a Kessler suture distally, using non-absorbable 4-strand 6-strand repairs and absorbable 8-strand sutures.
Multi-strand suture techniques were developed to gain improved gap resistance and ultimate force compared with the respective two-strand techniques.
Thirty three percent of failure was due to knot failure and half of these (n = 2) occurred in the absorbable 8-strand suture.
When trying to critically analyze the literature, in each study one finds that the tendon repair technique, number of strands, suture material and suture diameter between control and experimental groups change, making it difficult to compare the results.
The hamstring tendon was doubled, the strands sutured together and then sutured under tension to the superomedial edge of the patella and the medial epicondyle.
Finally 6 specimens were repaired using 8-strand Maxon sutures.
In Group 2, 7 specimens were repaired using 6-strand Fiberwire sutures.
In Group 1, 6 specimens were prepared using 4-strand Fiberwire sutures.
To experimentally assess the model, we evaluated single strands of sutures coated with highly flexible cyanoacrylates (Loctite 4903 and 4902), cyanoacrylate (Loctite QuickTite Instant Adhesive Gel), rubber cement, rubber/gasket adhesive (1300 Scotch-Weld Neoprene High Performance Rubber & Gasket Adhesive), an albumin-glutaraldehyde adhesive (BioGlue), or poly(dopamine).
We think that leakage of the contrast medium is due to an incomplete tendon-to-bone sealing, especially near suture anchors, or to an interstitial passage of the liquid among the fibrillated tendon fibers, especially if multiple strands of sutures are passed in the pulley technique through the cuff, creating large holes.
In the 6-strand barbed suture technique an increased breaking force and significantly less repair site bunching have been recorded, compared with 4-strand cruciate repair.
