Abstract

In vitro biomechanical testing is common in the field of orthopedics when novel devices are investigated prior to human trials. It is typically necessary to apply loads through tendons to simulate normal activities, such as walking during a foot and ankle study. However, attachment of tendons to linear actuators has proven challenging because of the tendency of clamps to either slip off or rupture the tendon. Various techniques have been utilized. Freeze clamping is generally accepted as the gold standard for very high load testing in excess of 3000 N, but is expensive, time-consuming, and requires significant ancillary equipment. Purely mechanical solutions such as metal jaw clamps, wire meshes, and others have been explored, but these techniques are either costly, have low load capacities, or have not proven to be reproducible. We have developed a novel tendon clamping technique that utilizes a slip-resistant polyester mesh sleeving that encases the tendon and is fixated at the bottom of the tendon/sleeve interaction with a giftbox suture. The loose end of the sleeving can then be tied in to the linear actuator or load cell apparatus using a timber hitch knot. The sleeving technique allows for loads of 2000–2500 N on the Achilles tendon, and is inexpensive, reproducible, and can be modified to apply loads to smaller tendons as well, though a length of tendon/sleeve overlap of at least 16 cm is required to reach maximum loads. This technique should assist researchers in integrating muscle forces into future biomechanical study designs.

References

1.
Riemersa
,
D. J.
, and
Schamhardt
,
H. C.
,
1982
, “
The Cryo-Jaw, a Clamp Designed for In Vitro Rheology Studies of Horse Digital Flexor Tendons
,”
J. Biomech.
,
15
(
8
), pp.
619
620
.10.1016/0021-9290(82)90073-2
2.
Lee
,
D. G.
, and
Davis
,
B. L.
,
2009
, “
Assessment of the Effects of Diabetes on Midfoot Joint Pressures Using a Robotic Gait Simulator
,”
Foot Ankle Int.
,
30
(
8
), pp.
767
772
.10.3113/FAI.2009.0767
3.
Noble
,
L. D. J.
,
Colbrunn
,
R. W.
,
Lee
,
D.-G.
,
van den Bogert
,
A. J.
, and
Davis
,
B. L.
,
2010
, “
Design and Validation of a General Purpose Robotic Testing System for Musculoskeletal Applications
,”
ASME J. Biomech. Eng.
,
132
(
2
), p.
25001
.10.1115/1.4000851
4.
Imsdahl
,
S. I.
,
Stender
,
C. J.
,
Cook
,
B. K.
,
Pangrazzi
,
G.
,
Patthanacharoenphon
,
C.
,
Sangeorzan
,
B. J.
, and
Ledoux
,
W. R.
,
2020
, “
Anteroposterior Translational Malalignment of Ankle Arthrodesis Alters Foot Biomechanics in Cadaveric Gait Simulation
,”
J. Orthop. Res. Off. Publ. Orthop. Res. Soc.
,
38
(
2
), pp.
450
458
.10.1002/jor.24464
5.
Cheung
,
J. T.-M.
, and
Zhang
,
M.
,
2006
, “
A Serrated Jaw Clamp for Tendon Gripping
,”
Med. Eng. Phys.
,
28
(
4
), pp.
379
382
.10.1016/j.medengphy.2005.07.010
6.
Hangody
,
G.
,
Pánics
,
G.
,
Szebényi
,
G.
,
Kiss
,
R.
,
Hangody
,
L.
, and
Pap
,
K.
,
2016
, “
Pitfalls During Biomechanical testing - Evaluation of Different Fixation Methods for Measuring Tendons Endurance Properties
,”
Physiol. Int.
,
103
(
1
), pp.
86
93
.10.1556/036.103.2016.1.8
7.
Shi
,
D.
,
Wang
,
D.
,
Wang
,
C.
, and
Liu
,
A.
,
2012
, “
A Novel, Inexpensive and Easy to Use Tendon Clamp for In Vitro Biomechanical Testing
,”
Med. Eng. Phys.
,
34
(
4
), pp.
516
520
.10.1016/j.medengphy.2011.11.019
8.
Zuber
,
T. J.
,
2002
, “
The Matrress Sutures: Vertical, Horizontal, and Corner Stitch
,”
Am. Fam. Phys.
,
66
(
12
), pp.
2231
2236
.https://pubmed.ncbi.nlm.nih.gov/12507160/
9.
Labib
,
S. A.
,
Rolf
,
R.
,
Dacus
,
R.
, and
Hutton
,
W.
, May
2009
, “
The “Giftbox” Repair of the Achilles Tendon: A Modification of the Krackow Technique
,”
Foot Ankle Int.
,
30
(
05
), pp.
410
414
.10.3113/FAI.2009.0410
10.
Sherry, J.,
2021
, “
Rope Knots
,” J. E. Sherry Company, Inc., Bend, OR, accessed Sept. 8, 2021, https://www.netknots.com/rope_knots
11.
Warner
,
C.
,
1996
, “
Studies on the Behavior of Knots
,”
History and Science of Knots
,
J.C.
Turner
,
P.
van de Griendeds
, eds.
World Scientific Publishing
,
Singapore
, pp.
181
201
.
12.
van den Bogert
,
A. J.
,
Geijtenbeek
,
T.
,
Even-Zohar
,
O.
,
Steenbrink
,
F.
, and
Hardin
,
E. C.
,
2013
, “
A Real-Time System for Biomechanical Analysis of Human Movement and Muscle Function
,”
Med. Biol. Eng. Comput.
,
51
(
10
), pp.
1069
1077
.10.1007/s11517-013-1076-z
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