34th Annual Scientific Meeting proceedings

Objectives:

Longitudinal tears of the Deep Digital Flexor Tendon (DDFT) carry a guarded prognosis for both tenoscopic debridement and open repair. Human literature suggests that the presence of knot and exposed suture increases inflammation and delays healing in open repair. A modified technique with knotless and self-anchoring barbed suture could resolve these issues and be beneficial in intrathecal tendon repair.

Methods:

Cadaver study: A standardised longitudinal lesion was induced along the lateral border of the DDFT in 20 cadaver limbs. There were repaired either with a size 3.5 Metric bidirectional barbed polydioxanone suture or a size 3 Metric non-barbed polydioxanone suture. The amount of suture material used, the surface area measurements of exposed suture material and exposed tendon tissue not covered by epitenon were measured and compared.

Case report: a 10 years-old Thoroughbred crossed gelding was presented for acute right hind lameness with distention of the digital flexor tendon sheath. Rehabilitation, intrathecal injections, and tenoscopic debridement all failed to improve the lameness. Open repair of the tear with a knotless barbed suture was performed 10 months after.

Results:

Barbed suture repair resulted in significantly less exposed tendon tissue, less exposed suture material and a lower amount of suture material used. The clinical case unresponsive to previous treatments returned to full work within 8 months and is still performing 3 years post-surgery.

Conclusions:

A knotless buried continuous pattern with barbed suture is a suitable alternative and merits consideration in longitudinal DDFT tears that fail to respond to tenoscopic debridement.