The use of N-butyl-2-cyanoacrylate (Histoacryl) in primary tendon repair: a biomechanical study with sheep flexor tendons

In this study, the biomechanical properties of peripheral tendon repair with the use of epitendinous suture technique and N-butyl-2-cyanoacrylate (Histoacryl) (NBSA), a biodegradable glue, were compared. Twenty-four flexor tendons were harvested from sheep hind limbs. Following transection of the tendons, 12 tendons (group 1) were repaired with modified Kessler core sutures using no 2 prolene and epitendinous running sutures with 3/0 prolene. In the other 12 tendons (group 2), NBSA was applied between the cut surfaces before placing modified Kessler core sutures. Placed on an hydrolic test machine, half of the tendons from each group were subjected to load to failure with a tensile force of 20 mm/min and the other half to cyclic loading with a tensile loading between 1-15 N at a rate of 20 cycles/min. Observation of a gap of 1 mm between the tendon ends in each test was regarded as repair failure. The mean load to failure was 27.3 N (range 25 to 32 N) for group 1 and 50.4 N (range 32 to 63 N) for group 2 (p=0.022). The mean number of cycles at failure was 140 (range 45 to 250) in group 1 and 350 (range 150 to 600) in group 2 (p=0.032). Our results showed that peripheral tendon repair with the use of NBSA has biomechanical advantages over repair with the epitendinous running suture technique.