Ex-vivo Evaluation of a Modified Teno Fix® Device Repair Pattern Versus a Three-Loop Pulley for Repair of Equine Flexor Tendons

Abstract

Current techniques for equine tendon laceration repair are not strong enough to support the normal load placed on equine tendons, which can be up to 450 kg at standing rest. Repairs can result in further wound healing complications including compromised blood flow, adhesion formation, development of excessive scar tissue, and serve as a foreign body for infection. Previous research into use of the Teno Fix® stainless steel tendon fixation system for equine tendon laceration repair revealed that repair using four devices was similar in strength of resistance to a standard three-loop pulley suture technique in the prevention of a 2mm gap at the repair site. However, the Teno Fix® repair was weaker than the three-loop pulley in regards to maximum load it could withstand before failure. Development of a different implant configuration using the Teno Fix® system that may provide an option for a stronger repair is warranted due to other benefits of the repair, which include minimal inflammation and development of scar tissue, as well as minimal interference with tendon healing based on previous studies. This project will evaluate the Teno Fix® stainless steel tendon fixation system compared to the three-loop pulley, utilizing the implants applied at staggering distances on either side of the tendon laceration, to evaluate the effect of suture pattern on maximum pull-out strength and gap formation. Our hypothesis was that by distributing strain at staggered distances from the laceration, it would increase the ultimate strength and strength to a 2mm gap of the fixation device repair. The repair configuration also allowed for insertion of an additional implant for evaluation of the effect of the number of stainless steel anchors on repair strength.