Development of a new suturing technique for tendon graft preparation: An animal cadaver study

•A new suturing technique for tendon reconstruction should be developed.•For this purpose ten different suturing techniques were analyzed.•The newly developed technique provides promising results.

BackgroundThis study should analyze ten different suturing techniques for tendon graft preparation to allow the development of an entirely new suturing technique.MethodsExtensor tendon grafts of fattening bulls' forelegs were sutured with Ethibond Excel size three (six metric) fibers (Ethicon, Somerville, New York, USA). The tendon/suture complexes were biomechanically tested with a hydraulic testing machine applying traction according to a standardized protocol. The testing was observed to find out why the failure at the maximum traction load occurred. The mean values for the maximum tension and extension stiffness were recorded for each suturing technique.FindingsAn entirely new suturing technique was developed based on the observations and biomechanical results. The newly developed suture was also tested and provided a higher traction stability than the other ten techniques that had been evaluated. Compared to the other ten techniques the new technique was ranked 3rd in terms of extension stiffness and reached 10.3 N/mm.InterpretationThe new technique evolved in the course of this study provided promising results. Therefore this study provides initial evidence that this technique could be useful in clinical routine.