Yohei Ono1, Denis A Joly2, Gail M Thornton3, Ian K Y Lo4. 1. Section of Orthopaedic Surgery, Department of Surgery, McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB, Canada; Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan. 2. Section of Orthopaedic Surgery, Department of Surgery, McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB, Canada. 3. Section of Orthopaedic Surgery, Department of Surgery, McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB, Canada; Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada. 4. Section of Orthopaedic Surgery, Department of Surgery, McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB, Canada. Electronic address: ikylo@ucalgary.ca.
Abstract
BACKGROUND: High-strength sutures, including #2 and tape-type, are popular when performing arthroscopic rotator cuff repair. Although the most common mechanism of anatomic failure of rotator cuff repair is suture pulling through tendon, the effect of sutures on the suture-tendon interface has rarely been investigated. We evaluated the effect of commercially available modern high-strength standard #2 and tape-type sutures on tendon. METHODS: Isolated sutures (FiberTape, #2 FiberWire [Arthrex Inc., Naples, FL, USA], Ultratape, and #2 Ultrabraid [Smith & Nephew, Andover, MA, USA]) and suture-tendon constructs using sheep infraspinatus tendons were evaluated using mechanical testing and imaging (microcomputed tomography) techniques. RESULTS: For the 4 suture-tendon constructs evaluated, maximum and residual displacements were all less than 3 mm. Whether evaluating isolated sutures or suture-tendon constructs, tape-type sutures had smaller displacements than standard #2 sutures when products from the same company were compared. On initial suture passing and after mechanical testing, hole volume was larger in constructs with tape-type rather than standard #2 sutures comparing within the same company. Collectively, constructs with larger hole volumes after mechanical testing had stiffer sutures. The percentage difference in hole volume was larger for standard #2 than tape-type sutures: FiberWire (43%), Ultrabraid (17%), FiberTape (11%), and Ultratape (9%). CONCLUSIONS: Tape-type sutures created larger final holes than standard #2 sutures from the same company. When initially passed through the tendon, tape-type sutures produced larger holes than standard #2 sutures; however, standard #2 sutures enlarged their initially smaller holes more and displaced more than tape-type sutures during cyclic loading, which suggests that tape-type sutures may be protective to suture pulling through tendon.
BACKGROUND: High-strength sutures, including #2 and tape-type, are popular when performing arthroscopic rotator cuff repair. Although the most common mechanism of anatomic failure of rotator cuff repair is suture pulling through tendon, the effect of sutures on the suture-tendon interface has rarely been investigated. We evaluated the effect of commercially available modern high-strength standard #2 and tape-type sutures on tendon. METHODS: Isolated sutures (FiberTape, #2 FiberWire [Arthrex Inc., Naples, FL, USA], Ultratape, and #2 Ultrabraid [Smith & Nephew, Andover, MA, USA]) and suture-tendon constructs using sheep infraspinatus tendons were evaluated using mechanical testing and imaging (microcomputed tomography) techniques. RESULTS: For the 4 suture-tendon constructs evaluated, maximum and residual displacements were all less than 3 mm. Whether evaluating isolated sutures or suture-tendon constructs, tape-type sutures had smaller displacements than standard #2 sutures when products from the same company were compared. On initial suture passing and after mechanical testing, hole volume was larger in constructs with tape-type rather than standard #2 sutures comparing within the same company. Collectively, constructs with larger hole volumes after mechanical testing had stiffer sutures. The percentage difference in hole volume was larger for standard #2 than tape-type sutures: FiberWire (43%), Ultrabraid (17%), FiberTape (11%), and Ultratape (9%). CONCLUSIONS: Tape-type sutures created larger final holes than standard #2 sutures from the same company. When initially passed through the tendon, tape-type sutures produced larger holes than standard #2 sutures; however, standard #2 sutures enlarged their initially smaller holes more and displaced more than tape-type sutures during cyclic loading, which suggests that tape-type sutures may be protective to suture pulling through tendon.
Authors: Catherine M Rapp; Denise M Koueiter; Jeremy Bojnowski; Jeremy Kalma; Brett Wiater; Michael D Kurdziel; J Michael Wiater Journal: Orthop J Sports Med Date: 2021-10-19
Authors: Christopher Alexander Becker; Adrian Cavalcanti Kussmaul; Eduardo Manuel Suero; Markus Regauer; Matthias Woiczinski; Christian Braun; Wilhelm Flatz; Oliver Pieske; Christian Kammerlander; Wolfgang Boecker; Axel Greiner Journal: J Orthop Surg Res Date: 2019-12-27 Impact factor: 2.359
Authors: Adrian Cavalcanti Kußmaul; Fanny Schwaabe; Manuel Kistler; Clara Gennen; Sebastian Andreß; Christopher A Becker; Wolfgang Böcker; Axel Greiner Journal: Arch Orthop Trauma Surg Date: 2021-05-29 Impact factor: 2.928