Surgical time for graft preparation using different suture techniques

Background: The purpose of the present study was to compare the operative time for graft prepa- ration using different techniques for graft sutur- ing. Material and methods: Flexor profundus tendons were harvested from fresh pig hind-leg trotters. Three different suture techniques were investigat- ed: the Krackow stitch (K), the Whipstitch (W), and the Modified Finger-Trap suture (MFT). Ten- dons were sutured starting at 10 mm from the dis- tal free end of the tendon. The suture configura- tions of the Krackow stitch and Whipstitch were completed with five suture throws. According to the MFT technique, the suture was wrapped five times around the tendon over a distance of 30 mm. The time required to perform a complete su- ture on each tendon was measured. Five indepen- dent examiners of different levels of training mea- sured the time required for graft preparation dur- ing 3 separate occasions to determine intraob- server repeatability and interobserver reproduci- bility. Results: The mean time required for graft prepa- ration following the Krackow technique was 69.1 seconds ± 18.3 SD (range 31.8-120). The Whip- stitch technique took an average of 59.9 seconds ± 21.2 SD (range 27-93). The MFT suture required a mean of 29.3 seconds ± 11.4 SD for completing the suture (range 21.6-33). In all examiners the time required to complete the MFT suture was significantly less than the other suture tech- niques (p < 0.05). Intraobserver intraclass correla- tion coefficients for each examiner ranged from 0.72 to 0.83. Conclusion: Low graft preparation time is re- quired to complete a MFT suture in a porcine ten- don model. Further, time required for graft prepa- ration using the MFT was shorter than other su- turing techniques such as the Krackow and Whip- stitch techniques. Clinical relevance: The MFT suture could be used for graft set-up with the main advantage of reduc- ing the time required in comparison with other su- ture techniques.