Abstract
BACKGROUND: We developed a new, simple 8-strand suture technique, termed the Yoshizu cross-lock repair. The technique allows sufficient tensile strength to counter the 2-mm gap formation force based on static analyses with a linear loading test, which does not consider cycling conditions during repetitive passive or light active motion activities. METHODS: Twelve porcine flexor tendons were transected and repaired using the Yoshizu cross-lock system; no peripheral sutures were placed. The repaired tendons were subjected to a cyclic loading test. The number of tendons that formed a 2-mm gap at the repair site during 20 cycles was determined. The resistance at the first and 20th loading cycles, the gap distance between the 2 tendon ends after cyclic loading, and the ultimate breaking strengths were recorded. RESULTS: No tendons repaired with the Yoshizu cross-lock repair formed a 2-mm gap during the 20 cycles of the cyclic loading test. The mean resistance was 3.9 ± 0.2 Newtons (N)/mm during the first cycle, and 6.1 ± 0.2 N/mm during the 20th cycle. The mean gap at the repair site after cyclic loading was 0.56 ± 0.62 mm, and the mean ultimate strength was 73.9 ± 6.8 N. CONCLUSIONS: This study suggested that the Yoshizu cross-lock repair has sufficient tensile strength based on a cyclic loading test. This suture technique is reliable and can be used with confidence for flexor tendon repair, which requires early active mobilization.