Chih-Kai Hong1, Ming-Long Yeh2, I-Ming Jou3, Cheng-Li Lin3, Chih-Hsun Chang1, Wei-Ren Su4. 1. Department of Medicine, National Cheng Kung University College of Medicine, Tainan, Taiwan. 2. Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan; Medical Device Innovation Center, National Cheng Kung University, Tainan, Taiwan. 3. Medical Device Innovation Center, National Cheng Kung University, Tainan, Taiwan; Department of Orthopaedic Surgery, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan. 4. Medical Device Innovation Center, National Cheng Kung University, Tainan, Taiwan; Department of Orthopaedic Surgery, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan. Electronic address: suwr@ms28.hinet.net.
Abstract
PURPOSE: The purpose of this study was to evaluate the tendon graft holding strength of 3 needleless grasping suture techniques, namely the modified Prusik knot, Wittstein suture loop, and modified rolling hitch. METHODS: Thirty fresh-frozen porcine flexor profundus tendons were used and randomly divided into 3 groups of 10 specimens. The experimental procedure was designed to assess elongation of the suture-tendon construct across 3 different needleless tendon-grasping techniques. All suture configurations were completed with a multistranded nonabsorbable suture. Each tendon was pre-tensioned to 100 N for 3 cycles, cyclically loaded to 200 N for 200 cycles, and then finally loaded to failure. Elongation, load to failure, and mode of failure for each suture-tendon construct were measured. RESULTS: During cyclic loading, there were no significant differences in elongation for any of the tested suture-tendon constructs (modified rolling hitch, 21.2% ± 9.6%; modified Prusik knot, 21.4% ± 9.9%; and Wittstein suture loop, 26.2% ± 4.5%). Similarly, the failure load and cross-sectional area were not significantly different across all tested suture groups. CONCLUSIONS: The modified Prusik knot, Wittstein suture loop, and modified rolling-hitch techniques had equal elongation after cyclic loading, as well as load to failure, in this in vitro biomechanical evaluation. CLINICAL RELEVANCE: These needleless grasping suture techniques may be an attractive alternative to the commonly used whipstitch techniques for tendon graft fixation in ligament reconstruction.
PURPOSE: The purpose of this study was to evaluate the tendon graft holding strength of 3 needleless grasping suture techniques, namely the modified Prusik knot, Wittstein suture loop, and modified rolling hitch. METHODS: Thirty fresh-frozen porcine flexor profundus tendons were used and randomly divided into 3 groups of 10 specimens. The experimental procedure was designed to assess elongation of the suture-tendon construct across 3 different needleless tendon-grasping techniques. All suture configurations were completed with a multistranded nonabsorbable suture. Each tendon was pre-tensioned to 100 N for 3 cycles, cyclically loaded to 200 N for 200 cycles, and then finally loaded to failure. Elongation, load to failure, and mode of failure for each suture-tendon construct were measured. RESULTS: During cyclic loading, there were no significant differences in elongation for any of the tested suture-tendon constructs (modified rolling hitch, 21.2% ± 9.6%; modified Prusik knot, 21.4% ± 9.9%; and Wittstein suture loop, 26.2% ± 4.5%). Similarly, the failure load and cross-sectional area were not significantly different across all tested suture groups. CONCLUSIONS: The modified Prusik knot, Wittstein suture loop, and modified rolling-hitch techniques had equal elongation after cyclic loading, as well as load to failure, in this in vitro biomechanical evaluation. CLINICAL RELEVANCE: These needleless grasping suture techniques may be an attractive alternative to the commonly used whipstitch techniques for tendon graft fixation in ligament reconstruction.
Authors: Shahbaz S Malik; Darren Hart; Sara Parashin; Jason Peeler; Sheila McRae; Peter MacDonald Journal: Clin Orthop Relat Res Date: 2022-03-01 Impact factor: 4.755