Suture Attachment to the Proximal Tendon using Cross-Lock

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  1. The 3-0 multi filament stainless steel suture is attached to each tendon end using a single cross lock stitch
  2. The first pass is made perpendicular to the long axis of the tendon 10 to 12mm from the cut end. The suture is pulled through so the strand lengths are equal – this will facilitate passing the strands through the crimp later
  3. Two more passes are made across the tendon and both of these are done  5 to 6 mm from the cut end. These passes are also perpendicular to the long axis of the tendon. Each needle is brought over to the opposite side of the tendon and passed through the center of the tendon at this distance. Care is taken  not to lock the stitch as the needle is withdrawn from the tendon
  4. Starting a few mm distal to the exit point of the stitch that has been placed, the needle is passed through the tendon and out the center of the cut end with a simple gliding stitch. This exit should be close to the center of the tendon with the sutures from both sides close to each other. This facilitates later passage of the strands through the crimp
  5. This creates a strong simple cross lock stitch. It is important to firmly pull the sutures to flatten and embed the cross-lock onto the surface of the tendon. This takes up any slack and reduces 2mm gap and friction
  6. The tendon is now ready to be passed to the repair site using the PONTiS catheter and funnel –  see video

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