# PRECONDITIONING OF PORCINE FLEXOR TENDONS FOR APPLICATION IN RECONSTRUCTION OF HAND FLEXOR TENDONS

**Authors:** Raquel Bernardelli Iamaguchi, Cesar Augusto Martins Pereira, Gustavo Bispo dos Santos, Flavio Elias Santiago do Nascimento, Heitor Pereira Vale da Costa, Rames Mattar

PMC · DOI: 10.1590/1413-785220253306e295649 · Acta Ortopedica Brasileira · 2025-11-10

## TL;DR

This study explores how preconditioning porcine tendons can improve their use in reconstructing hand tendons by optimizing tension and deformation.

## Contribution

The study introduces a method of preconditioning porcine tendons to determine optimal graft tension for hand reconstruction.

## Key findings

- Porcine tendons showed an average elongation of 2.3 mm under 50 N tension.
- Residual elongation of 0.6 mm was observed, indicating viscoelastic properties.
- Preconditioning with loads up to 70 N is recommended for optimal graft performance.

## Abstract

In chronic hand flexor tendon reconstruction with tendon grafts, the challenge is to obtain the best resistance and tension of the suture that allows early active mobility. This experimental study of tension relaxation aims to investigate whether prior preconditioning of the tendon graft could assist to identify the ideal tendon graft tension in these reconstructions.

The porcine flexor tendons were subjected to the tension relaxation test, with three test cycles each with up to 50 N of tension and relaxation for 300 seconds. Measured: maximum force (N), maximum tension (Mpa) and maximum deformation.

After the peak tension of 50 N, the following was observed: maximum deformation, with an average tendon elongation of 2.3 mm; average residual tendon elongation of 0.6 mm; demonstrating the viscoelastic spring characteristic of porcine tendons.

We recommend performing intraoperative preconditioning of the tendon graft with loads close to active grip strength (50 N to 70 N). If it is impossible to perform preconditioning, the suture can be placed 17 degrees of flexion of the proximal interphalangeal joint above the cascade flexion of fingers, compensating for tendon elongation under a load of 50 N. 
Level of Evidence III; Experimental
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## Linked entities

- **Species:** Sus scrofa (taxon 9823)

## Full-text entities

- **Diseases:** FLEXOR TENDONS (MESH:D052582)

## Full text

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## Figures

2 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12599819/full.md

## References

17 references — full list in the complete paper: https://tomesphere.com/paper/PMC12599819/full.md

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Source: https://tomesphere.com/paper/PMC12599819