EFFECT OF SUTURE KNOT LOCATION ON TENSILE-STRENGTH AFTER FLEXOR TENDON REPAIR

This study investigated the effect of increased suture material within the flexor tendon repair site on tensile strength in a canine model a fter in vivo healing. Four-strand modified Savage suture repairs with the knots located either inside or outside the repair site were perfor med in dogs. The tendons were placed on a passive-motion protocol afte r surgery and were biomechanically tested at 1, 3, and 6 weeks of in v ivo healing. The knots-outside technique ini tially was 1.14 kg strong er on load-to-failure testing. After 6 weeks of healing, the knots-ins ide tendons had equal tensile strength (3.91 +/- 0.50 kg [inside] vs 4 .16 +/- 0.66 kg [outside]). Relative tensile strength compared to init ial strength showed an increase of 20% for the knots-outside technique and an increase of 67% for the knots-inside technique after 6 weeks. Suture material within the repair site did not have any deleterious ef fects on tensile strength and may stimulate tendon healing.