Mechanical Comparison of High-Strength Tape Suture Versus High-Strength Round Suture

Abstract

Purpose: To compare knot and loop characteristics of commonly used high-strength tapes and high-strength round sutures. Methods: Twenty tied 30-mm loops were prepared for using suture-knot combinations of 4 common arthroscopic knots or a hand-tied surgeon's knot and 7 sutures. Two tapes (BroadBand, SutureTape) and three no. 2 sutures (MaxBraid, FiberWire, DynaCord) were compared. Two additional larger tape sutures (FiberTape, PermaTape) not commonly tied arthroscopically were included in the hand-tied group. Each suture-knot combination was evaluated for loop integrity (single load to a specified elongation), knot security (plastic loop deformation with cyclic testing), loop security, and knot volume. Data were compared using analysis of variance followed by Tukey-Kramer post hoc tests.Results: BroadBand and SutureTape demonstrated superior loop integrity compared to most no. 2 suture-knot combinations. FiberTape (430.48 AE 89.00 N) and PermaTape (545.16 AE 95.09 N) required significantly greater force to undergo 3 mm of displacement than all other hand-tied sutures (P < .001). All suture-knot configurations demonstrated significant plastic deformation (cyclic elongation) over 1000 cycles (P < 0.001). DynaCord displayed the best loop security except when paired with the Duncan loop. Overall, BroadBand and SutureTape had lower knot volumes compared to all other sutures. Conclusion: This study exhibits the ability of narrow tape sutures to provide reliable tissue apposition and fixation in multiple suture-knot configurations, while decreasing the potential adverse effects accompanying knot prominence. Generally, BroadBand and SutureTape demonstrated an ideal balance of mechanical characteristics to achieve the optimal suture-knot construct among those tested. Dynacord displayed superior loop security and performed best among round sutures. PermaTape and FiberTape showed greater loop integrity, albeit to the detriment of loop security and knot volume. Clinical Relevance: When securing a rotator cuff repair construct with a knot, one should have a basic understanding of the mechanical properties of the suture and knot being used to provide the best possible repair. This study will provide information about the mechanical characteristics of commonly used high-strength tape suture knots and loops to help determine what knot type may provide the best overall construct.

Primary closure combined with C-tube drainage through cystic duct after laparoscopic common bile duct exploration is safe and feasible for patients

“…2. The C-tube is always ligated and fixed with a slip knot (Duncan knot) ( 23 ). When tightening the knot, surgeons should not over-tighten it so as to maintain the patency of the drainage tube, however, pipe slippage may be caused by a loose knot.…”

Non-metallic Fixation of Patella Fractures: A Paradigm Shift

“…Patella fractures in patients with high risk for infection will probably be treated with antibiotic-coated sutures in the future to overcome the phenomenon of biofilm associated with metallic implants which are associated with persistent infection [ 20 ] while the efficacy of self-tightening suture material (DYNACORD) for patella fracture fixation has yet to be investigated [ 21 ].…”

Influence of Loading Conditions on the Mechanical Performance of Multifilament Coreless UHMWPE Sutures Used in Orthopaedic Surgery

“…The mechanical properties of sutures may include those of the suture material [ 4 , 5 , 6 , 12 ], suture knots [ 13 , 14 ] and the suture–tissue interface [ 15 , 16 ]. Focusing on the suture material, the tensile strength parameter related to the capacity to withstand loads before failure is the only mechanical property standardised for sutures in the United States Pharmacopeia (USP) [ 9 ] or European Pharmacopeia [ 17 ], and it is the most widely reported mechanical property in the scientific literature.…”

“…Following United States Pharmacopoeia standards, the ultimate failure loads were determined in load-to-failure tests conducted at single-loading velocities [ 4 , 5 , 6 , 12 ]. The knot security of different knots was analysed in terms of knot strength and slipping resistance measured as plastic deformation after cyclic tests at normal physiological load levels [ 13 , 14 , 19 , 20 ]. In addition, viscoelastic static and dynamic creeps were characterised for suture strands alone [ 21 , 22 ] or tied with knots [ 15 ] in tests that, again, were conducted at single loading velocities.…”