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First published on August 10, 2005, doi:10.1177/0363546505275492
This version was published on November 1, 2005
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The American Journal of Sports Medicine 33:1729-1734 (2005)
© 2005 American Orthopaedic Society for Sports Medicine

Suture Plication, Thermal Shrinkage, and Sclerosing Agents

Effects on Rat Patellar Tendon Length and Biomechanical Strength

Arun Aneja, Spero G. Karas, MD, Paul S. Weinhold, PhD, Hessam M. Afshari and Laurence E. Dahners, MD*

From the Department of Orthopaedics, University of North Carolina, Chapel Hill, North Carolina

* Address correspondence to Laurence E. Dahners, MD, CB# 7055, Department of Orthopaedics, University of North Carolina, Chapel Hill, NC 27599 (e-mail: LED{at}med.unc.edu).

Background: Shortening or tightening of dense, collagenous tissues is often desirable in the treatment of laxity.

Purpose: To compare the effect of stress-protection suture, radiofrequency thermal shrinkage combined with stress-protection suture, and a 5% sodium morrhuate sclerosing injection on the length and biomechanical strength of the rat patellar tendon.

Hypothesis: Sclerosing agents will increase tendon mechanical strength. Thermal shrinkage combined with stress-protection suture and stress-protection suture only will cause a short-term decrease in tendon strength. All 3 methods will produce equivalent shortening of the tendon.

Study Design: Controlled laboratory study.

Methods: Forty-six female retired breeder rats were split into 4 groups, each receiving 1 of the 3 aforementioned treatments plus a control group that received a saline injection. After 4 weeks’ survival, the length and biomechanical properties of the patellar tendons were measured and compared to the contralateral untreated tendon.

Results: Rats treated with stress-protection suture had shorter tendons. Radiofrequency thermal shrinkage combined with stress-protection suture yielded tendons that were both shorter and stronger than were the untreated contralateral tendons. The sodium morrhuate–injected tendons were stronger whereas the saline-treated tendons were weaker than were their respective untreated contralateral tendons.

Conclusion: Surgical stress-protection suture without radiofrequency shrinkage is most effective at shortening the length of the rat patellar tendon, whereas radiofrequency thermal shrinkage combined with stress-protection suture as well as sodium morrhuate are effective at increasing the strength of rat patellar tendons.

Clinical Relevance: Judicious use of thermal shrinkage in combination with stress protection may improve ligament strength and decrease laxity.

Key Words: sclerosing agents • prolotherapy • stress-protection suture • thermal shrinkage




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K. T. Jensen, D. P. Rabago, T. M. Best, J. J. Patterson, and R. Vanderby Jr
Response of Knee Ligaments to Prolotherapy in a Rat Injury Model
Am. J. Sports Med., July 1, 2008; 36(7): 1347 - 1357.
[Abstract] [Full Text] [PDF]


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