Ex Vivo Biomechanical Assessment of Various Repair Techniques in a Rabbit Calcaneal Tendon Avulsion Model: Application of Polycaprolactone Plate

Simple Summary Tendon injuries are a disease that can occur in small animals and may require surgical correction. There are various suture methods for primary tendon repair, and techniques to reinforce these suture methods are currently being researched. This is the first study to apply a plate made of polycaprolactone (biodegradable, biocompatible, and non-toxic implantable biomaterial) to tendon plating. In addition, the polycaprolactone plate was compared biomechanically with conventional tendon reinforcement methods including titanium plates. This study was aimed at evaluating the biomechanical properties and gapping characteristics of tendon repair methods using a combination of a three-loop pulley (3LP) pattern, a titanium plate, and a polycaprolactone (PCL) plate in a rabbit gastrocnemius tendon (GT) model (n = 50). GTs were randomly assigned to five groups (n = 10/group). Transected GTs were repaired with a 3LP pattern alone or in conjunction with an epitendinous suture (ES), a 5-hole 1 mm PCL plate, a 5-hole 2 mm PCL plate, or a 5-hole 1.5 mm titanium plate. The yield, peak, and failure force, as well as the occurrence and force of 1-mm and 3-mm gapping were examined. The mean yield, peak, and failure force of the 3LP + titanium plate group were higher than that of other groups. The biomechanical properties of a 3LP + a 2 mm PCL plate were similar to 3LP + ES constructs in this model. In all specimens in all groups, 1 mm gap formation was observed. The frequency of 3 mm gap formation was 70% and 90% in the 3LP + 2 mm PCL plate group and the 3LP + 1.5 mm titanium plate group, respectively. Additional studies evaluating PCL plates to determine the effect on the healing and blood supply of tendon are needed.

Automated summary

This study applied a polycaprolactone plate to tendon plating for the first time, compared its biomechanical properties with conventional methods, and evaluated the gap characteristics. The results showed that the 3LP + titanium plate group had the highest force values, and the biomechanical properties of the 3LP + a 2 mm PCL plate were similar to the 3LP + ES constructs. Gap formation was observed in all groups, with a higher frequency in the 3LP + 1.5 mm titanium plate group.