Ex vivo strength comparison of bioabsorbable tendon plates and bioabsorbable suture in a 3-loop pulley pattern for repair of transected flexor tendons from horse cadavers.
Authors: Jenson Paul W, Lillich James D, Roush James K, Gaughan Earl M
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Bioabsorbable Tendon Plates for Equine Flexor Tendon Repair Deep digital flexor tendon (DDFT) injuries remain a significant challenge in equine practice, and the optimal surgical repair technique—particularly regarding fixation method and early load-bearing capacity—remains debated. This cadaveric biomechanical study compared the immediate failure strength of poly-L-lactic acid tendon plates versus traditional 3-loop pulley suture repairs in transected DDFTs from adult horses, using polydioxanone suture in both techniques. Plated repairs demonstrated substantially superior strength, with mean peak failure force of 1507 N compared to just 461 N for sutured repairs—more than three-fold greater—whilst total energy absorption at failure also favoured the plate construct. Whilst these findings reflect ex vivo conditions on fresh cadaveric tissue and do not account for the inflammatory response and biological healing cascade that occurs in living horses, the dramatic difference in immediate mechanical strength suggests bioabsorbable plates may warrant investigation in clinical settings, potentially allowing reduced reliance on external coaptation during early healing phases when the repair is most vulnerable.
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Practical Takeaways
- •Bioabsorbable tendon plates offer substantially stronger initial repair strength than traditional pulley suture methods in laboratory conditions, which could allow reduced external support during early healing
- •These results are promising but in vivo validation is needed before clinical adoption—cadaveric tissue properties differ from living, healing tendons
- •If clinical trials confirm these findings, plate fixation could improve outcomes for horses with transected DDFT by reducing external coaptation burden during the critical early healing phase
Key Findings
- •Bioabsorbable plate repairs demonstrated significantly greater peak failure force (1507 N) compared to 3-loop pulley suture repairs (461 N)
- •Total energy at failure was significantly higher for plate-repaired tendons versus suture repairs
- •Plate fixation provides superior immediate strength in cadaveric DDFT repairs, potentially reducing need for external coaptation during healing