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Optimum Locations Of The Locking Loop And Knot In Tendon Sutures Based On The Locking Kessler Method

Tadahiko Yotsumoto, R. Mori, Y. Uchio
Published 2005 · Medicine

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BackgroundWe investigated the factors that influence tensile strength and resistance to gap formation at the repair site of tendon suture (stiffness) by comparing (1) the location of the locking loops and (2) the location of the knot.MethodsTransected bovine tendons of the medial gastrocnemius (9-11 × 14-16 mm diameter) were sutured with a modified locking Kessler method with a USP (United States Pharmacopeial convention) 2 polyester multifilament suture (0.500-0.599 mm) and loaded to failure using an Instron 5565 tensiometer. The locking loops were located on either the upper surface facing the operator or on side portions of the tendon. The knot was positioned either close to or far from the tendon stump.ResultsThe locations of the locking loops did not influence the tensile strength; however, the stiffness of the side loop suture (5.70 ± 0.09 N/mm) was significantly higher than that of the upper surface loop suture (5.17 ± 0.10 N/mm). Regarding the knot location, the tensile strength with the knot far from the tendon stump (195.1 ± 4.8 N) was significantly higher than that with the knot close to the tendon stump (169.0 ± 3.6 N), although the stiffness was unchanged by differences in knot location.ConclusionsThese data suggested that a greater tensile strength with less of a gap is obtained by (1) forming locking loops in the side portion of the tendon, and (2) forming knots far from the tendon stump.
This paper references
Effect of suture knot location on tensile strength after flexor tendon repair.
Donald L. Pruitt (1996)
Gliding characteristics and gap formation for locking and grasping tendon repairs: a biomechanical study in a human cadaver model.
T. Tanaka (2004)
Early Active Motion and Weightbearing After Cross-Stitch Achilles Tendon Repair
M. Aoki (1998)
The effect of gap formation at the repair site on the strength and excursion of intrasynovial flexor tendons. An experimental study on the early stages of tendon-healing in dogs.
R. Gelberman (1999)
Differences between locking loops and grasping loops: effects on 2-strand core suture.
S. Hotokezaka (1997)
An in vivo study of locking and grasping techniques using a passive mobilization protocol in experimental animals.
H. Hatanaka (2000)
Periacetabular osteotomy in the treatment of neurogenic acetabular dysplasia.
S. Macdonald (1999)
Comparison of Postoperative Early Active Mobilization and Immobilization in Vivo Utilising a Four-Strand Flexor Tendon Repair
A. Wada (2001)
Aggressive active mobilization following zone II flexor tendon repair using a two-strand heavy-gauge locking loop technique
H. Hatanaka (2002)
Effect of the cross-sectional area of locking loops in flexor tendon repair.
H. Hatanaka (1999)
The Locking Loop Tendon Suture
D. Pennington (1979)
Flexor tendon repair
R. Gelberman (1986)
The Influence of Protected Passive Mobilization on the Healing of Flexor Tendons: A Biochemical and Microangiography Study
R. Gelberman (1981)

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K. Ryoke (2014)
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S. Imade (2011)
Over-The-Top Knot Placement Technique Enhances Tensile Stability of Tendon Repairs
Onder Kõlõ (2010)
Optimum location of knot for tendon surgery in side-locking loop technique.
F. Komatsu (2007)
Re: Rigo IZ and Røkkum M. Predictors of outcome after primary flexor tendon repair in zone 1, 2 and 3. J Hand Surg Eur. 2016, 41: 793–801.
J. Chen (2017)
Modification of side-locking loop suture technique using an antislip knot for repair of Achilles tendon rupture.
S. Imade (2013)
Flexor tendon repair in fingers: Suture technique, postoperative rehabilitation and predictors of outcome
István Zoltán Rigó (2017)
Single side locking on the opposite of the modified Kessler tendon repair prevents gap formation and suture pull-out: a biomechanical evaluation in sheep tendons.
Yunus Doğramacı (2009)
踵骨裂離骨折に対しside-locking loop suture法を用い縫合固定した1例
拓也 若槻 (2013)
Novel Approach to Repair of Acute Achilles Tendon Rupture
Tadahiko Yotsumoto (2010)
Flexor tendon repair using the two-strand side-locking loop technique to tolerate aggressive active mobilization immediately after surgery.
S. Kuwata (2007)
Comparison of elastic versus rigid suture material for peripheral sutures in tendon repair.
K. Nozaki (2012)
Avulsion fracture of the calcaneal tuberosity treated using a side-locking loop suture (SLLS) technique through bone tunnels.
Takuya Wakatsuki (2016)
The effect of adding active flexion to modified Kleinert regime on outcomes for zone 1 to 3 flexor tendon repairs. A prospective randomized trial
I. Z. Rigó (2017)
Fixation for Avulsion Fracture of the Calcaneal Tuberosity Using a Side-Locking Loop Suture Technique and Anti–Slip Knot
W. Miyamoto (2015)
Biomechanical evaluation of a novel suturing scheme for grafting load-bearing collagen scaffolds for rotator cuff repair.
A. Islam (2015)
Biomechanical differences resulting from the combination of suture materials and repair techniques
Nobuo Yamagami (2006)
Comparison of Transverse Intraosseous Loop Technique and Pull Out Suture for Reinsertion of the Flexor Digitorum Profundus tendon. A Retrospective Study
I. Z. Rigó (2013)
Over-The-Top Knot Placement Technique Enhances Tensile Stability of Tendon Repairs
Mehmet Türker (2010)
Optimum suture material for locking technique in tendon repair: effects of suture friction in mobilization.
Nobuo Yamagami (2011)
Evaluating different closed loop graft preparation technique for tibial suspensory fixation in ACL reconstruction using TightRope™
T. Sasho (2018)
Comparison of modified Kessler and Yotsumoto-Dona suture: A biomechanical study on porcine tendons
I. Z. Rigó (2012)
Optimally strong tendon repair using braided polyethylene strand: 2-strand heavy-gauge locking technique vs. multiple-strand technique.
Tadahiko Yotsumoto (2010)
Predictors of outcome after primary flexor tendon repair in zone 1, 2 and 3
I. Z. Rigó (2016)
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