The use of bidirectional barbed suture in the treatment of a complete common calcanean tendon rupture in a dog: Long‐term clinical and ultrasonographic evaluation

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Abstract

The canine common calcanean tendon can be repaired successfully using a modified Kessler knotless barbed technique. A long‐term ultrasound follow‐up showed improved and increased normal tendon fibrillar echotexture and homogeneity.

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Most cited references 55

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Early motion of the ankle after operative treatment of a rupture of the Achilles tendon. A prospective, randomized clinical and radiographic study.

Uffe Mortensen, Lilli Ø Skov, Leif P Jensen (1999)

Different regimens of early motion of the ankle after operative treatment of a ruptured Achilles tendon have been suggested since the late 1980s. However, as far as we know, no controlled studies comparing these regimens with conventional immobilization in a cast have been reported. In a prospective study, seventy-one patients who had an acute rupture of the Achilles tendon were randomized to either conventional postoperative management with a cast for eight weeks or early restricted motion of the ankle in a below-the-knee brace for six weeks. The brace was modified with an elastic band on the posterior surface, in a manner similar to the principle of Kleinert traction. Metal markers were placed in the tendon, and the separation between them was measured on serial radiographs during the first twelve weeks postoperatively. The patients were assessed clinically when the cast or brace was removed, at twelve weeks postoperatively, and at a median of sixteen months postoperatively. The separation between the markers at twelve weeks postoperatively was nearly identical in the two groups, with a median separation of 11.5 millimeters (range, zero to thirty-three millimeters) in the patients managed with early motion of the ankle and nine millimeters (range, one to forty-one millimeters) in the patients managed with a cast. The separation was primarily correlated with the initial tautness of the repair (r[S] = 0.45). No patient had excessive lengthening of the tendon. The patients managed with early motion had a smaller initial loss in the range of motion, and they returned to work and sports activities sooner than those managed with a cast. Furthermore, there were fewer visible adhesions between the repaired tendon and the skin in the patients managed with early motion, and these patients were subjectively more satisfied with the overall result. The patients in both groups recovered a median of 89 percent of strength of plantar flexion compared with that of the noninjured limb, as measured with an isometric strain-gauge at 15 degrees of dorsiflexion. The heel-rise index was similar for both groups: 0.88 for the patients managed with early motion and 0.89 for those managed with a cast. Early restricted motion appears to shorten the time needed for rehabilitation. There were no complications related to early motion in these patients. However, early unloaded exercises did not prevent muscle atrophy.

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Breaking strength of barbed polypropylene sutures: rater-blinded, controlled comparison with nonbarbed sutures of various calibers.

David S. Yoo, Murad Alam, R. Rashid … (2007)

To assess the strength of 2.0 barbed polypropylene suture, and, specifically, to determine the load required to break this suture, and to compare this with the strength of nonbarbed polypropylene suture. Rater-blinded, controlled trial. The individual responsible for setting up the experimental conditions was not blinded. Biomechanics laboratory in an academic medical center. This study did not include human subjects. Materials used included six 2.0 barbed polypropylene sutures and 3 each of 2.0, 3.0, 4.0, and 5.0 nonbarbed polypropylene sutures. Each suture was randomly selected from a different batch or box of similar sutures. Each suture was strung between 2 (top and bottom) cylinders and tied with a surgeon's knot. A tensile testing device was used to apply increasing force until the suture broke. Data were acquired through an analog-to-digital board on an IBM-compatible computer using commercially available software. Ultimate strength, stiffness, and elongation before suture rupture. Strength of the barbed sutures (mean [SD] ultimate strength, 39.5 [9.0] N) was intermediate between that of 2.0 (55.0 N) and 3.0 (36.4 N) nonbarbed sutures and was not significantly different from that of 3.0 nonbarbed sutures (P = .5). Barbed 2.0 polypropylene sutures differed significantly (P < .001) from each of the other types of nonbarbed sutures on measures of stiffness and elongation. Elongation of barbed sutures was closest to that of 3.0 nonbarbed sutures (P = .002). Stiffness of the barbed sutures (mean [SD], 4.7 [0.7] N/mm) was markedly in excess of that of any of the other suture types (P < .001). Barbed 2.0 polypropylene sutures seem to be at least as strong as 3.0 nonbarbed polypropylene sutures. As such, barbed sutures are significantly stronger than their rated strength, which has been stated as comparable to 4.0 nonbarbed sutures. This has implications for the long-term in vivo safety of barbed sutures.

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Monitoring of the repair process of surgically created lesions in equine superficial digital flexor tendons by use of computerized ultrasonography.

Hans van Schie, Erwin M Bakker, Worakij Cherdchutham … (2009)

To evaluate quantitative ultrasonography for objective monitoring of the healing process and prognostication of repair quality in equine superficial digital flexor (SDF) tendons.

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Author and article information

Contributors

Ron Ben‐Amotz:

ORCID: https://orcid.org/0000-0002-3898-192X

ronba1@gmail.com

Journal

Journal ID (nlm-ta): Clin Case Rep

Journal ID (iso-abbrev): Clin Case Rep

Journal ID (doi): 10.1002/(ISSN)2050-0904

Journal ID (publisher-id): CCR3

Title: Clinical Case Reports

Publisher: John Wiley and Sons Inc. (Hoboken )

ISSN (Electronic): 2050-0904

Publication date (Electronic): 10 July 2019

Publication date Collection: August 2019

Volume: 7

Issue: 8 ( doiID: 10.1002/ccr3.v7.8 )

Pages: 1565-1572

Affiliations

[ ¹ ] Veterinary Specialty and Emergency Center Bluepearl Veterinary Partners Philadelphia Pennsylvania

[ ² ] Rambam 80, Hand and Microsurgery Unit Healthcare Campus Haifa Israel

[ ³ ] Cape Cod Veterinary Specialists Buzzards Bay Massachusetts

Author notes

[*] [* ] Correspondence

Ron Ben‐Amotz, Veterinary Specialty and Emergency Center, Bluepearl Veterinary Partners, 1114 South Front Street, Philadelphia, PA 19147.

Email: ronba1@ 123456gmail.com

Author information

Ron Ben‐Amotz https://orcid.org/0000-0002-3898-192X

Article

Publisher ID: CCR32287

DOI: 10.1002/ccr3.2287

PMC ID: 6692997

PubMed ID: 31428393

SO-VID: d0f3a8b7-f934-4141-8cb7-aa8cebdb83c2

License:

This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

History

Date received : 08 March 2019

Date revision received : 31 May 2019

Date accepted : 04 June 2019

Page count

Figures: 4, Tables: 0, Pages: 8, Words: 5496

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component-id ccr32287

cover-date August 2019

details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_NLMPMC version:5.6.7 mode:remove_FC converted:14.08.2019

The use of bidirectional barbed suture in the treatment of a complete common calcanean tendon rupture in a dog: Long‐term clinical and ultrasonographic evaluation

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Most cited references 55

Early motion of the ankle after operative treatment of a rupture of the Achilles tendon. A prospective, randomized clinical and radiographic study.

Breaking strength of barbed polypropylene sutures: rater-blinded, controlled comparison with nonbarbed sutures of various calibers.

Monitoring of the repair process of surgically created lesions in equine superficial digital flexor tendons by use of computerized ultrasonography.

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