Partial flexor carpi radialis tendon transfer technique for midcarpal instability

demonstrated, however, that the knot outside the repair was stronger only early in the healing process; they found no difference between inside and outside knot repair strength 6 weeks after. Recently, a knotless, asymmetric repair was reported to be even stronger compared with the Lim/Tsai configuration, highlighting that the knot was the weakest link in flexor tendon repairs (Lim et al., 2018). There are several limitations to this study. First, we did not add an epitendinous suture to our repair configurations before testing. This was done on purpose to avoid extra variables when analysing the results, but might not truly reflect the flexor tendon repair configurations used in vivo. Second, this is a basic science study, and the ex vivo setup might not mimic the in vivo environment. The knot position outside of the repair zone might be more prone to adhesions compared with the inside position, whereas the inside position causes decreased tendon-to-tendon contact in vivo. Lastly, the repair constructs were loaded to failure and did not undergo cyclic testing.