Evaluation of 3 needleless grasping suture techniques for soft-tissue graft fixation

A porcine biomechanical study

Chih Kai Hong, Ming-Long Yeh, I. Ming Jou, Cheng-Li Lin, Chih Hsun Chang, Wei-Ren Su

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Purpose The purpose of this study was to evaluate the tendon graft holding strength of 3 needleless grasping suture techniques, namely the modified Prusik knot, Wittstein suture loop, and modified rolling hitch. Methods Thirty fresh-frozen porcine flexor profundus tendons were used and randomly divided into 3 groups of 10 specimens. The experimental procedure was designed to assess elongation of the suture-tendon construct across 3 different needleless tendon-grasping techniques. All suture configurations were completed with a multistranded nonabsorbable suture. Each tendon was pre-tensioned to 100 N for 3 cycles, cyclically loaded to 200 N for 200 cycles, and then finally loaded to failure. Elongation, load to failure, and mode of failure for each suture-tendon construct were measured. Results During cyclic loading, there were no significant differences in elongation for any of the tested suture-tendon constructs (modified rolling hitch, 21.2% ± 9.6%; modified Prusik knot, 21.4% ± 9.9%; and Wittstein suture loop, 26.2% ± 4.5%). Similarly, the failure load and cross-sectional area were not significantly different across all tested suture groups. Conclusions The modified Prusik knot, Wittstein suture loop, and modified rolling-hitch techniques had equal elongation after cyclic loading, as well as load to failure, in this in vitro biomechanical evaluation. Clinical Relevance These needleless grasping suture techniques may be an attractive alternative to the commonly used whipstitch techniques for tendon graft fixation in ligament reconstruction.

Original languageEnglish
Pages (from-to)1151-1155
Number of pages5
JournalArthroscopy - Journal of Arthroscopic and Related Surgery
Volume31
Issue number6
DOIs
Publication statusPublished - 2015 Jun 1

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Tissue Fixation
Suture Techniques
Sutures
Tendons
Swine
Transplants
Ligaments

All Science Journal Classification (ASJC) codes

  • Orthopedics and Sports Medicine

Cite this

@article{d02532ae66c344d8a69b111f184304f0,
title = "Evaluation of 3 needleless grasping suture techniques for soft-tissue graft fixation: A porcine biomechanical study",
abstract = "Purpose The purpose of this study was to evaluate the tendon graft holding strength of 3 needleless grasping suture techniques, namely the modified Prusik knot, Wittstein suture loop, and modified rolling hitch. Methods Thirty fresh-frozen porcine flexor profundus tendons were used and randomly divided into 3 groups of 10 specimens. The experimental procedure was designed to assess elongation of the suture-tendon construct across 3 different needleless tendon-grasping techniques. All suture configurations were completed with a multistranded nonabsorbable suture. Each tendon was pre-tensioned to 100 N for 3 cycles, cyclically loaded to 200 N for 200 cycles, and then finally loaded to failure. Elongation, load to failure, and mode of failure for each suture-tendon construct were measured. Results During cyclic loading, there were no significant differences in elongation for any of the tested suture-tendon constructs (modified rolling hitch, 21.2{\%} ± 9.6{\%}; modified Prusik knot, 21.4{\%} ± 9.9{\%}; and Wittstein suture loop, 26.2{\%} ± 4.5{\%}). Similarly, the failure load and cross-sectional area were not significantly different across all tested suture groups. Conclusions The modified Prusik knot, Wittstein suture loop, and modified rolling-hitch techniques had equal elongation after cyclic loading, as well as load to failure, in this in vitro biomechanical evaluation. Clinical Relevance These needleless grasping suture techniques may be an attractive alternative to the commonly used whipstitch techniques for tendon graft fixation in ligament reconstruction.",
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Evaluation of 3 needleless grasping suture techniques for soft-tissue graft fixation : A porcine biomechanical study. / Hong, Chih Kai; Yeh, Ming-Long; Jou, I. Ming; Lin, Cheng-Li; Chang, Chih Hsun; Su, Wei-Ren.

In: Arthroscopy - Journal of Arthroscopic and Related Surgery, Vol. 31, No. 6, 01.06.2015, p. 1151-1155.

Research output: Contribution to journalArticle

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T1 - Evaluation of 3 needleless grasping suture techniques for soft-tissue graft fixation

T2 - A porcine biomechanical study

AU - Hong, Chih Kai

AU - Yeh, Ming-Long

AU - Jou, I. Ming

AU - Lin, Cheng-Li

AU - Chang, Chih Hsun

AU - Su, Wei-Ren

PY - 2015/6/1

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N2 - Purpose The purpose of this study was to evaluate the tendon graft holding strength of 3 needleless grasping suture techniques, namely the modified Prusik knot, Wittstein suture loop, and modified rolling hitch. Methods Thirty fresh-frozen porcine flexor profundus tendons were used and randomly divided into 3 groups of 10 specimens. The experimental procedure was designed to assess elongation of the suture-tendon construct across 3 different needleless tendon-grasping techniques. All suture configurations were completed with a multistranded nonabsorbable suture. Each tendon was pre-tensioned to 100 N for 3 cycles, cyclically loaded to 200 N for 200 cycles, and then finally loaded to failure. Elongation, load to failure, and mode of failure for each suture-tendon construct were measured. Results During cyclic loading, there were no significant differences in elongation for any of the tested suture-tendon constructs (modified rolling hitch, 21.2% ± 9.6%; modified Prusik knot, 21.4% ± 9.9%; and Wittstein suture loop, 26.2% ± 4.5%). Similarly, the failure load and cross-sectional area were not significantly different across all tested suture groups. Conclusions The modified Prusik knot, Wittstein suture loop, and modified rolling-hitch techniques had equal elongation after cyclic loading, as well as load to failure, in this in vitro biomechanical evaluation. Clinical Relevance These needleless grasping suture techniques may be an attractive alternative to the commonly used whipstitch techniques for tendon graft fixation in ligament reconstruction.

AB - Purpose The purpose of this study was to evaluate the tendon graft holding strength of 3 needleless grasping suture techniques, namely the modified Prusik knot, Wittstein suture loop, and modified rolling hitch. Methods Thirty fresh-frozen porcine flexor profundus tendons were used and randomly divided into 3 groups of 10 specimens. The experimental procedure was designed to assess elongation of the suture-tendon construct across 3 different needleless tendon-grasping techniques. All suture configurations were completed with a multistranded nonabsorbable suture. Each tendon was pre-tensioned to 100 N for 3 cycles, cyclically loaded to 200 N for 200 cycles, and then finally loaded to failure. Elongation, load to failure, and mode of failure for each suture-tendon construct were measured. Results During cyclic loading, there were no significant differences in elongation for any of the tested suture-tendon constructs (modified rolling hitch, 21.2% ± 9.6%; modified Prusik knot, 21.4% ± 9.9%; and Wittstein suture loop, 26.2% ± 4.5%). Similarly, the failure load and cross-sectional area were not significantly different across all tested suture groups. Conclusions The modified Prusik knot, Wittstein suture loop, and modified rolling-hitch techniques had equal elongation after cyclic loading, as well as load to failure, in this in vitro biomechanical evaluation. Clinical Relevance These needleless grasping suture techniques may be an attractive alternative to the commonly used whipstitch techniques for tendon graft fixation in ligament reconstruction.

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SN - 0749-8063

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