Biomechanical Comparison of Krackow Locking Stitch Versus Nonlocking Loop Stitch With Varying Number of Throws

Hahn, J.; İnceoğlu, Serkan; Wongworawat, Montri D.

doi:10.1177/0363546514550989

Cited by 31 publications

(55 citation statements)

References 21 publications

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“…The parameters in the biomechanical testing protocol were in accordance to previous studies. 1,4,9,[15][16][17][18][19][20][21] All specimens were initially pretensioned to 100 N at a rate of 100 mm/min for 3 cycles and then preloaded to 50 N for 1 minute. After that, each specimen was cyclically loaded between 50 and 200 N with a cross-head speed of 200 mm/min for 200 cycles.…”

Section: Biomechanical Testingmentioning

confidence: 99%

The Biomechanical Properties of a High-Tensile Strength Tape for Tendon Graft Fixation Using the Krackow Configuration

Hong

Hsu

Kuan

et al. 2020

Arthroscopy, Sports Medicine, and Rehabilitation

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To compare the biomechanical properties of a high-tensile strength suture with the high-tensile strength tape for tendon graft fixation. Methods: A total of 24 porcine tendons were used and were randomly divided into 2 groups. Two kinds of suture materials, a braided nonabsorbable high-strength suture (group S) and a high-tensile strength tape (group T), were used to complete 3 pairs of Krackow stitches on the tendons. Each specimen was pretensioned to 100 N for 3 cycles, cyclically loaded from 50 to 200 N for 200 cycles, and finally loaded to failure. Elongation after cyclic loading, ultimate failure load, and the mode of failure were recorded. Results: The elongation after cyclic loading between group S (26% AE 5%) and group T (24% AE 5%) were not significantly different (P ¼ .378). The ultimate failure loads in group T (400 AE 38 N) were significantly greater than those in group S (358 AE 21 N) (P ¼ .010). All specimens failed because of suture material breakage. Conclusions: Compared with the braided nonabsorbable high-strength suture, the high-tensile strength tape had similar elongation values after cyclic loading, but significantly greater ultimate failure load in this porcine in vitro biomechanical model. Clinical Relevance: A secure suture-tendon construct is especially important when a post-tie fixation technique is used because the mitigating construct may potentially lead to graft loosening and affect graft healing.

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Section: Biomechanical Testingmentioning

confidence: 99%

The Biomechanical Properties of a High-Tensile Strength Tape for Tendon Graft Fixation Using the Krackow Configuration

Hong

Hsu

Kuan

et al. 2020

Arthroscopy, Sports Medicine, and Rehabilitation

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“…reported that there is no relationship between the increase in the number of loops and the decrease in elongation and increase in strength against failure when more than 4 loops were applied. 14 McKeon et al. and Hong CK et al.…”

Section: Discussionmentioning

confidence: 99%

Evaluating different closed loop graft preparation technique for tibial suspensory fixation in ACL reconstruction using TightRope™

Sasho

Sasaki

Hoshi

et al. 2018

Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilit

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In most anterior cruciate ligament (ACL) reconstructions, grafts are fixed to the femoral side first followed by the tibial side. Various techniques have been reported to achieve optimal tension on the grafts, but once the grafts are fixed it is difficult to adjust graft tension further. To enable post fixation tension control we have invented a new graft configuration using an adjustable loop-device (TightRopeTM, Arthrex, FL, USA) on the tibial side. In this paper, biomechanical properties of this configuration using soft tissue were examined in terms of graft diameter and various suture techniques (referred to as base suture) to make a closed circle to support TightRopeTM.Two experiments were conducted under different conditions. In each experiment, cyclic load, followed by a pull-to-failure load, was applied to the grafts and elongation and failure mode were recorded. (1) To evaluate the effects of diameter, 5.0 or 6.0 mm grafts were prepared by a single locking loop stitch as the base suture (SLL5, SLL6). (2) To evaluate different base sutures, 5.0 mm tendons were used, and grafts were prepared using five kinds of base sutures (SLL, ZLL: zigzag locking loop, DZLL: double zigzag locking loop, DK: double Krackow, DK w/o TR: double Krackow without TightRopeTM). In the first experiment, tearing was observed in 2 of 6 cases in the SLL5 test group, whereas no tearing was observed with SLL6. In the second experiment, no tearing was observed with DZLL or DK. Elongation was smaller in these two groups compared to the other groups. Mechanical strength decreases with a smaller graft diameter. Biomechanical properties differed with different base sutures and, among them, the double-zigzag-suture stitch and double Krackow provided less elongation and higher ultimate load in this graft configuration.

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“…1,2 In addition, early rehabilitation protocols, which allow early weight bearing and range of motion, are dependent on resistance to gap formation. 1,2,3,4 Various studies have been performed to identify the suture technique that provides the greatest resistance to gap formation. These studies compare new suture configurations as well as varying the number of throws in known suture configurations.…”

Section: Introductionmentioning

confidence: 99%

“…These studies assess gap formation, load to failure, and failure mode. 4,5,7 The Krackow stitch is recommended due to its greater resistance to gap formation. 4 Mechanisms of gap formation include suture tear-out, 4 suture material elasticity, 8 knot failure 9 and suture slack.…”

Section: Introductionmentioning

confidence: 99%

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A novel method for reducing gap formation in tendon repair

Dean

2018

Journal of Orthopaedics

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Biomechanical Comparison of Krackow Locking Stitch Versus Nonlocking Loop Stitch With Varying Number of Throws

Cited by 31 publications

References 21 publications

The Biomechanical Properties of a High-Tensile Strength Tape for Tendon Graft Fixation Using the Krackow Configuration

The Biomechanical Properties of a High-Tensile Strength Tape for Tendon Graft Fixation Using the Krackow Configuration

Evaluating different closed loop graft preparation technique for tibial suspensory fixation in ACL reconstruction using TightRope™

A novel method for reducing gap formation in tendon repair

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