TY - JOUR
T1 - A Biomechanical Evaluation of Various Double Krackow Suture Techniques for Soft-Tissue Graft Fixation
AU - Hong, Chih Kai
AU - Lin, Cheng Li
AU - Kuan, Fa Chuan
AU - Wang, Ping Hui
AU - Yeh, Ming Long
AU - Su, Wei Ren
N1 - Publisher Copyright:
© 2017 Arthroscopy Association of North America
PY - 2018/3
Y1 - 2018/3
N2 - Purpose: The purpose of this study was to compare the biomechanical properties among the different double Krackow suture techniques for tendon graft fixation. Methods: Thirty porcine flexor profundus tendons were randomly divided into 3 groups of 10 specimens each. Three different double Krackow suture techniques were evaluated, namely, the McKeon's double Krackow (MDK) suture, Wilson's double Krackow (WDK) suture, and Ostrander's modified Krackow (OMK) suture. All suture configurations were completed with a braided nonabsorbable suture. Each suture-tendon construct was pretensioned to 100 N for 3 cycles, cyclically loaded from 50 to 200 N for 200 cycles, and then finally loaded to failure. Elongation after cyclic loading, ultimate load to failure, and the mode of failure were recorded for each specimen. Results: There were significant differences in elongation after cyclic loading among the MDK suture (7.9 ± 3.6 mm, 14% ± 6%), WDK suture (11.6 ± 2.2 mm, 22% ± 3%), and OMK suture (9.6 ± 3.3 mm, 17% ± 6%; P =.018). In addition, although the post hoc analysis showed that elongation after cyclic loading in the MDK suture was significantly less than the WDK suture (P =.004), ultimate failure load and cross-sectional area were not significantly different across the 3 groups. Conclusions: In this porcine in vitro biomechanical study, the MDK suture had significantly smaller elongation after cyclic loading than the WDK suture; however, high elongation values may have a potential for risk of clinical laxity. The ultimate failure load was not different across the MDK, WDK, and OMK sutures. Clinical Relevance: Smaller elongation during cyclic loading in a suture-tendon construct represents a lower possibility of tendon graft loosening after ligament reconstruction surgery. The double Krackow suture techniques are attractive options for tendon graft fixation in ligament reconstruction, and the MDK suture could possibly be the optimal choice among the double Krackow suture techniques.
AB - Purpose: The purpose of this study was to compare the biomechanical properties among the different double Krackow suture techniques for tendon graft fixation. Methods: Thirty porcine flexor profundus tendons were randomly divided into 3 groups of 10 specimens each. Three different double Krackow suture techniques were evaluated, namely, the McKeon's double Krackow (MDK) suture, Wilson's double Krackow (WDK) suture, and Ostrander's modified Krackow (OMK) suture. All suture configurations were completed with a braided nonabsorbable suture. Each suture-tendon construct was pretensioned to 100 N for 3 cycles, cyclically loaded from 50 to 200 N for 200 cycles, and then finally loaded to failure. Elongation after cyclic loading, ultimate load to failure, and the mode of failure were recorded for each specimen. Results: There were significant differences in elongation after cyclic loading among the MDK suture (7.9 ± 3.6 mm, 14% ± 6%), WDK suture (11.6 ± 2.2 mm, 22% ± 3%), and OMK suture (9.6 ± 3.3 mm, 17% ± 6%; P =.018). In addition, although the post hoc analysis showed that elongation after cyclic loading in the MDK suture was significantly less than the WDK suture (P =.004), ultimate failure load and cross-sectional area were not significantly different across the 3 groups. Conclusions: In this porcine in vitro biomechanical study, the MDK suture had significantly smaller elongation after cyclic loading than the WDK suture; however, high elongation values may have a potential for risk of clinical laxity. The ultimate failure load was not different across the MDK, WDK, and OMK sutures. Clinical Relevance: Smaller elongation during cyclic loading in a suture-tendon construct represents a lower possibility of tendon graft loosening after ligament reconstruction surgery. The double Krackow suture techniques are attractive options for tendon graft fixation in ligament reconstruction, and the MDK suture could possibly be the optimal choice among the double Krackow suture techniques.
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U2 - 10.1016/j.arthro.2017.09.025
DO - 10.1016/j.arthro.2017.09.025
M3 - Article
C2 - 29229418
AN - SCOPUS:85037621633
SN - 0749-8063
VL - 34
SP - 663
EP - 668
JO - Arthroscopy - Journal of Arthroscopic and Related Surgery
JF - Arthroscopy - Journal of Arthroscopic and Related Surgery
IS - 3
ER -