Abrasiveness of high-strength sutures used in rotator cuff surgery: are they all the same?

Background The suture–tendon interface remains the most common point of failure in rotator cuff repairs via suture pullout. Several high-strength braided sutures are available for rotator cuff surgery and are more abrasive than monofilaments. However, a comparison of these sutures has not been perfo...

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Bibliographic Details
Published in:Journal of shoulder and elbow surgery 2016, Vol.25 (1), p.142-148
Main Authors: Williams, Johnathan F., MD, Patel, Shaan S., BS, Baker, Dustin K., BS, Schwertz, Joseph M., MS, McGwin, Gerald, PhD, Ponce, Brent A., MD
Format: Article
Language:English
Subjects:
abrasion
Animals
braided suture
Equipment Design
Friction
Orthopedic Procedures
Orthopedics
repair strength
rotator cuff
Rotator Cuff - surgery
Rupture - etiology
Sheep
Shoulder
Surface Properties
Sutures - adverse effects
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Summary:Background The suture–tendon interface remains the most common point of failure in rotator cuff repairs via suture pullout. Several high-strength braided sutures are available for rotator cuff surgery and are more abrasive than monofilaments. However, a comparison of these sutures has not been performed in a tissue model. Methods Ninety infraspinatus sheep tendons were randomized among 9 groups of sutures (n = 10), including FiberWire (Arthrex, Naples, FL, USA), Collagen Coated FiberWire (Arthrex), Orthocord (DePuy Mitek, Raynham, MA, USA), MaxBraid (Biomet, Warsaw, IN, USA), Force Fiber (Teleflex, Research Triangle Park, NC, USA), ULTRABRAID (Smith & Nephew, Memphis, TN, USA), Phantom Fiber BioFiber (Tornier, Bloomington, MN, USA), and Ti-Cron (Syneture, Mansfield, MA), with Surgipro (Syneture) monofilament as a control. Each suture was cycled 50 times through the tendon, which was fixed to a mechanical testing system under a constant load in saline solution. The distance cut through the tendon was measured and divided by the distance of suture sliding to determine displacement (mm/cm). Twist angle and picks per inch of each suture were measured using digital photography. One-way analysis of variance was used to compare the displacement and twist angle between sutures. Results Collagen Coated FiberWire was the most abrasive of the high-strength sutures. Four of the sutures (Collagen Coated FiberWire, Phantom Fiber BioFiber, FiberWire, Ti-Cron) had a mean displacement rate greater than 0.150 mm/cm. The remainder of the sutures had a mean displacement rate less than 0.050 mm/cm (Orthocord, Force Fiber, MaxBraid, ULTRABRAID). The difference in the displacement rates between these 2 groups was significant ( P  
ISSN:1058-2746
1532-6500
DOI:10.1016/j.jse.2015.07.018