Biomechanical superiority of novel dynamic tape over standard tape suture in distal triceps tendon repair: a human cadaveric study testing an intense early rehabilitation protocol

Background

Distal triceps tendon rupture is related to high complication rates with up to 25% failures. Elbow stiffness is another severe complication, as the traditional approach considers prolonged immobilization to ensure tendon healing. Recently, a dynamic tape was designed, implementing a silicone-infused core for braid shortening and preventing repair elongation during mobilization, thus maintaining constant tissue approximation. The aim of this study was to compare biomechanically the novel dynamic tape versus conventional tape in a human cadaveric distal triceps tendon repair model.

Methods

Sixteen paired arms from eight donors were split to two groups. Distal triceps tendon tenotomies and repairs were performed via the crossed transosseous locking Krackow stitch technique for anatomic footprint repair. Either conventional (SutureTape) or the novel dynamic tape (DYNATape) were used. A postoperative protocol mimicking intense early rehabilitation was simulated by a 9-day, 300-cycle daily mobilization under 150 N load followed by a final destructive test.

Results

Significant differences were identified between the groups regarding the displacement over time at the distal, intermediate, and proximal tendon aspects, p < 0.001. DYNATape demonstrated significantly less displacement compared to SutureTape (4.6 ± 1.2 mm versus 7.8 ± 2.1 mm) and higher load to failure (637 ± 113 N versus 341 ± 230 N), p ≤ 0.037. DYNATape retracted 0.95 ± 1.95 mm after each 24-hour period and withstood the whole cyclic loading sequence without failure. In contrast, SutureTape failed early in three specimens.

Conclusion

DYNATape demonstrated improved biomechanical competence compared to SutureTape in a distal triceps tendon repair model, with significantly lower maximal displacement and higher load to failure. These findings indicate that DYNATape may offer a more stable construct under controlled laboratory conditions. Knot slippage and bone-related complications observed in both groups underscore the technical challenges associated with this repair technique and highlight the importance of precise surgical execution.