The Interlocking Modification of the Cross Locked Cruciate Tendon Repair (Modified Adelaide Repair): A Static and Dynamic Biomechanical Assessment

Ramon Tahmassebi; Tim S. Peltz; Roger Haddad; Peter Scougall; Mark Gianoutsos; William Walsh

doi:10.1007/s12593-014-0144-4

Journal of Hand and Microsurgery, Table of Contents

J Hand Microsurg 2015; 07(01): 6-12
DOI: 10.1007/s12593-014-0144-4

Original Article

Thieme Medical and Scientific Publishers Private Ltd.

The Interlocking Modification of the Cross Locked Cruciate Tendon Repair (Modified Adelaide Repair): A Static and Dynamic Biomechanical Assessment

Authors

Ramon Tahmassebi

¹Kings College Hospital London, Denmark Hill, London, UK, SE5 9RS Email: rtahmassebi@doctors.org.uk
Tim S. Peltz

²Surgical and Orthopaedic Research Laboratories, University of New South Wales, Prince of Wales Hospital, Sydney, Australia

³The Department of Hand Surgery, Sydney and St Lukes Hospital, Sydney, Australia
Roger Haddad

²Surgical and Orthopaedic Research Laboratories, University of New South Wales, Prince of Wales Hospital, Sydney, Australia

³The Department of Hand Surgery, Sydney and St Lukes Hospital, Sydney, Australia
Peter Scougall

²Surgical and Orthopaedic Research Laboratories, University of New South Wales, Prince of Wales Hospital, Sydney, Australia

³The Department of Hand Surgery, Sydney and St Lukes Hospital, Sydney, Australia
Mark Gianoutsos

²Surgical and Orthopaedic Research Laboratories, University of New South Wales, Prince of Wales Hospital, Sydney, Australia

³The Department of Hand Surgery, Sydney and St Lukes Hospital, Sydney, Australia
William Walsh

²Surgical and Orthopaedic Research Laboratories, University of New South Wales, Prince of Wales Hospital, Sydney, Australia

³The Department of Hand Surgery, Sydney and St Lukes Hospital, Sydney, Australia

Subject Editor:

Abstract

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Abstract

The 4-strand cross-locked cruciate flexor tendon repair technique (Adelaide technique) has been shown to have comparably high resistance to gap formation and ultimate tensile strength. This study aimed to determine whether an interlocking modification to the Adelaide repair would impart improved biomechanical characteristics. Twenty four sheep flexor tendons were harvested, transected and repaired using either standard or modified Adelaide techniques. Repaired tendons were cyclically loaded. Gap formation and ultimate tensile strength were measured. Additionally, suture exposure on the tendon surface was determined. There was a statistically significant increase in resistance to gap formation in the early phase of cyclic loading within the modified Adelaide group. In the later stages of testing no significant difference could be noted. The average final load to failure in the modified group was higher than the standard group but this did not achieve statistical significance. Interlocking suture techniques in four strand tendon repair constructs can improve gapping behavior in the early phase of cyclic loading.

Keywords

Flexor tendon - Tendon repair - Locking stitch - Gap formation

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References

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