Investigation of the Effects of Two-, Four-, Six- and Eight-Strand Suture Repairs on the Biomechanical Properties of Canine Gastrocnemius Tenorrhaphy Constructs

Introduction: Various factors affect the biomechanical properties of the tenorrhaphy. Our objective was to determine the effect of two, four, six, and eight strand sutured repairs on the biomechanical properties of experimental canine tendons. Our hypothesis was that construct strength would be positively associated with an increasing number of suture strands crossing the repair site in this controlled canine research model.

Materials and Methods: Twenty-eight cadaveric gastrocnemius tendons were dissected and randomly assigned to four groups (n = 14/group). Tendons were repaired using a simple interrupted suture technique using a two, four, six, and eight strand techniques using 2–0 USP polypropylene suture. Biomechanical testing was performed with evaluation of yield, peak, and failure loads, gap formation between tendon ends and failure mode. Statistical significance was set at p <0.05.

Results: Increasing the number of strands significantly increased repair site strength (p <0.001). Use of an eight-strand repair demonstrated significantly higher tensile strength among groups (p <0.001), followed by 6-, 4-, and 2-strand. There was a significant positive correlation regarding resistance to 1- and 3-mm gap formation (p 0.001) as number of strands used for the construct repair increased. All sutured constructs failed by mode of suture pull-through.

Discussion/Conclusion: Increasing the number of suture strands crossing the repair site significantly increases the tensile strength and the resistance to gap formation of repaired canine gastrocnemius constructs. Suture patterns using multiple strands traversing the repair site should be recommended for canine tenorrhaphy.

Acknowledgement: There was no proprietary interest or funding provided for this project.

No conflict of interest has been declared by the author(s).

Publication History

Article published online:
26 October 2022