Biomechanical properties of porcine flexor tendon fixation with varying throws and stitch methods.
Am J Sports Med
; 40(7): 1641-5, 2012 Jul.
Article
en En
| MEDLINE
| ID: mdl-22691458
BACKGROUND: The well-known suture technique configurations used for hamstring tendon autograft preparation in anterior cruciate ligament (ACL) reconstruction are the Krackow locking stitch and nonlocking stitch, such as a baseball stitch and a whipstitch. However, there are few data in the literature regarding biomechanical comparisons of suture techniques. PURPOSE: The purpose of this study was to determine the properties of several current techniques of tendon graft suture employed in ACL reconstruction. STUDY DESIGN: Controlled laboratory study. METHODS: Forty-two fresh-frozen porcine flexor digitorum tendons were used. Three stitch configurations (Krackow stitch [group K], baseball stitch [group B], and whipstitch [group W]) were assessed with varying suture throws (6 throws, group×6; 10 throws, group×10) using No. 5 Ethibond sutures. Each group was tested at 1500 loading cycles between 50 and 200 N. After loading cycles, the surviving tendons underwent a load-to-failure test. RESULTS: During the loading cycles, 3 of 7 specimens in group B×6 and all specimens in group W×6 failed by suture pullout. Four of 7 specimens in group B×10 and all specimens in group W×10 showed partial tearing of the tendon. Elongation of group B×10 and group W×10 showed significantly greater elongation than other groups (P < .05). Maximum loads at failure showed significant differences between group K and the other groups (K×6, 436 ± 52 N; K×10, 419 ± 34 N; P < .05). Most specimens failed by rupture of the suture thread in group K. Pullout of the suture from the tendon was observed most in groups B and W. CONCLUSION: The Krackow stitch was superior to other stitch methods. There was, however, no significant effect of the number of throws on the holding strength. CLINICAL RELEVANCE: The Krackow stitch could prevent suture slippage by a locking mechanism. The whipstitch is not suitable for clinical application even with an increased number of throws.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Tendones
/
Técnicas de Sutura
/
Reconstrucción del Ligamento Cruzado Anterior
Límite:
Animals
Idioma:
En
Revista:
Am J Sports Med
Año:
2012
Tipo del documento:
Article
País de afiliación:
Japón
Pais de publicación:
Estados Unidos