Quantitative effect of tenorrhaphy on intrinsic vasculature of the equine superficial digital flexor tendon.

This research examines the impacts of two different suture patterns, the locking-loop suture pattern (LLP) and the 3-loop pulley suture pattern (3LP), on the amount of intrinsic vasculature (blood vessels) in horse tendons after surgical repair. The findings indicate that while both methods decreased the vascular density within the tendon, the 3LP method had less of an impact compared to the LLP method.

Methods Employed

• The study involved 16 forelimbs taken from 8 mature horses. The experiment took place in vitro, meaning it was performed in an artificial environment outside the living organism.
• After being anesthetized, the horses underwent a procedure known as tenotomy and subsequently tenorrhaphy – which involve the cutting and then stitching of the superficial digital flexor tendon (SDFT), respectively.
• Upon euthanizing the horses, the limbs were removed and placed under tension to stress the flexor tendons.
• The intrinsic vasculature (internal blood vessels) of the tendons was then perfused with a mixture of water and barium sulfate to make it visible for follow-up analysis.
• Cut sections (4mm in length) of the SDFT were then prepared and examined through a process called microangiographic analysis, which enables the visualization of minute blood vessels.
• The researchers then used a grid, consisting of squares measuring 1.5 mm2 each, known as vascular assessment squares (VAS) to calculate the mean vessel density which quantifies the amount of blood vessels in each section.

Study Findings

• Numeric data from this study showed a significant decrease in vascular density post-surgery: In the control group (untreated), LLP, and 3LP groups, the mean vascular densities were 3.11, 1.47, and 2.01 vessels/1.5 mm2, respectively.
• The analysis brought out significant differences in vascular density between the control and both suture pattern groups, plus a noted difference between the two suture techniques. These results suggest that the surgery, regardless of the suture pattern used, negatively impacts the intrinsic vasculature of the SDFT.

Conclusions

• While both methods posed damaging effects on the internal blood vessels within the tendon, the study concluded that the 3LP pattern caused less disruption compared to the LLP, indicating it as a more preferable option in clinical applications.
• This suggests that using the 3LP suture pattern in surgical repair of tendons may minimize the amount of damage to the tendon’s blood vessels during the recovery period.