Biomechanical comparison between the modified rolling-hitch and the modified finger-trap suture techniques

Pitarresi, Giuseppe; Fazzari, Federico; Tumino, Davide; D’Arienzo, Michele

doi:10.1007/s00402-016-2551-4

Cited by 8 publications

(15 citation statements)

References 24 publications

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“…In a biomechanical study, Hong et al [10] proposed the modified rolling hitch to be an attractive technique for suture-tendon constructs because it had similar elongation after cyclic loading and load to failure as the modified Prusik knot and Wittstein suture loop; additionally, Krappinger et al [12] found that the modified Prusik knot had smaller force-induced displacements than the whipstitch technique. However, whereas Camarda et al [2] reported that the modified rolling hitch provided better biomechanical properties than the modified finger-trap technique, Su et al [15] reported that the modified finger-trap featured superior biomechanical properties to the Krackow stitch. Although two prior studies [2,10] did not biomechanically compare the modified rolling hitch and the commonly used needled techniques directly, according to the above previous findings, we could infer that the modified rolling hitch may have comparable or better biomechanical properties compared with the whipstitch or Krackow stitch.…”

Section: Discussionmentioning

confidence: 99%

“…Although some biomechanical studies have suggested the modified rolling hitch to be effective in holding tendon grafts [2,10], to our knowledge no study has compared the traditional suture techniques with the modified rolling hitch or the rolling hitch. We biomechanically evaluated the rolling hitch, modified rolling hitch, and Krackow stitch for preparing tendon grafts.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have evaluated the biomechanical properties of the needleless suture techniques [2,10,12,15]. Krappinger et al [12] compared the modified Prusik knot with the whipstitch, and found that the modified Prusik knot had similar mechanical properties as the whipstitch technique.…”

Section: Introductionmentioning

confidence: 99%

“…Hong et al [10] evaluated the tendon graft holding strength of the modified Prusik knot, Wittstein suture loop, and modified rolling hitch; their results showed similar elongation after cyclic loading and loading to failure. Camarda et al [2] further characterized the biomechanical effect of the modified rolling hitch and modified finger-trap, the results of which showed that the modified rolling hitch resulted in less elongation during cyclic loading and higher stiffness than did the modified finger-trap.…”

Section: Introductionmentioning

confidence: 99%

“…Although previous studies have suggested the modified rolling hitch to be an attractive alternative [2,10], to our knowledge, no biomechanical study has simultaneously compared the holding strength of the modified rolling hitch or rolling hitch with the commonly used whipstitch. The aim of this study was to compare the biomechanical properties of the rolling hitch, modified rolling hitch, and Krackow stitch fixation.…”

Section: Introductionmentioning

confidence: 99%

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Do Needleless Knots have Similar Strength as the Krackow Suture? An In Vitro Porcine Tendon Study

Hong

Kuo

Yeh

et al. 2017

Clinical Orthopaedics &Amp; Related Research

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Background Numerous needleless techniques for tendon graft fixation that feature several advantages have been reported. However, there are few studies that have compared the holding strength between the needleless techniques (rolling hitch and modified rolling hitch) and traditional suture methods. Questions/purposes To compare the tendon graft-holding strength of the rolling hitch and modified rolling hitch with the Krackow stitch in an in vitro porcine biomechanical model. Methods Thirty fresh-frozen porcine flexor profundus tendons were randomly divided into three groups of 10 specimens. The experimental procedure was designed to assess elongation of the suture-tendon construct across the needleless tendon-grasping techniques and the Krackow stitch. All suture configurations were completed with a braided nonabsorbable suture. Each tendon was pretensioned to 100 N for three cycles, cyclically loaded from 50 to 200 N for 200 cycles, and then finally loaded to failure. Elongation, load to failure, and mode of failure were recorded for each specimen.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Do Needleless Knots have Similar Strength as the Krackow Suture? An In Vitro Porcine Tendon Study

Hong

Kuo

Yeh

et al. 2017

Clinical Orthopaedics &Amp; Related Research

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Superior biomechanical properties and tying time with the modified Prusik knot and Wittstein suture loop to the Krackow stitch

Hong

Lin

Yang

et al. 2017

Arch Orthop Trauma Surg

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The single-suture technique for anterior cruciate ligament graft preparation provides similar stability as a three-suture technique: a biomechanical in vitro study in a porcine model

Theopold¹,

Schleifenbaum

Georgi³

et al. 2020

Arch Orthop Trauma Surg

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Purpose Numerous techniques have been described for the tibial-sided graft preparation in anterior cruciate ligament (ACL) reconstruction. The use of less suture material for graft preparation is thought to improve ingrowth and to reduce the risk for infection. At the same time, the suture construct should be strong enough to resist the surgeon's pull during tensioning of the transplant. Methods In total, 39 fresh-frozen procine deep flexor tendons were used and prepared as four-strand grafts. In the three-suture group (n = 19), graft preparation was performed using three tibial-sided sutures, with each tendon end sutured separately. In the one-suture group (n = 20), a modified graft preparation using only one tibial-sided suture was applied. Each sample underwent load-to-failure testing (N max ) after cyclic pre-loading. To estimate intraoperative tension forces acting on the tibial-sided suture constructs, the maximal tension force of 26 volunteers on such a construct was measured using a load cell. Results The biomechanical testing of the two different suture constructs showed a significantly higher load-to-failure for the three-suture group (711 N ± 91 N) compared to the one-suture group (347 N ± 24 N) (p = 0.0001). In both groups, the mode of failure was a tear of the suture in all samples. A failure of the suture-tendon interface was not observed in any case. The median maximal tension force on the construct applied by the 26 volunteers was 134 N (range 73-182 N). Conclusion The presented single-suture tendon graft preparation resisted to smaller failure loads than the conventional three-suture technique. However, no failures in the suture-tendon interface were seen and the failure loads observed were far beyond the tension forces that can be expected intraoperatively. Hence, the single-suture graft preparation technique may be a valuable alternative to the conventional technique.Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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Biomechanical comparison between the modified rolling-hitch and the modified finger-trap suture techniques

Abstract: This study showed that both suture methods appear to be biomechanically effective in a porcine tendon model. However, the single-knot grasping technique (MRH) provided superior biomechanical properties compared with the MFT technique.

Cited by 8 publications

References 24 publications

Do Needleless Knots have Similar Strength as the Krackow Suture? An In Vitro Porcine Tendon Study

Do Needleless Knots have Similar Strength as the Krackow Suture? An In Vitro Porcine Tendon Study

Superior biomechanical properties and tying time with the modified Prusik knot and Wittstein suture loop to the Krackow stitch

The single-suture technique for anterior cruciate ligament graft preparation provides similar stability as a three-suture technique: a biomechanical in vitro study in a porcine model

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