Two new methods of tendon repair: An in vitro evaluation of tensile strength and gap formation

A new tendon repair design incorporating a mesh sleeve was, together with a new epitendinal suture technique (cross-stitch), tested biomechanically on sheep tendons. The mean breaking strength with a 6-0 suture was 103 N for the mesh sleeve repair and 63 N for the cross-stitch alone, both significantly greater than the 48 N recorded for the modified Kessler repair performed with a 4-0 polyester suture and reinforced with a circumferential conventional 6-0 epitendinal stitch. The cross-stitch grasp was 117% stronger than the conventional epitendinal grasp reinforced by a core stitch. The new techniques effectively prevented the large gaps that occurred in the modified Kessler repair.