A new stitch for ligament-tendon fixation. Brief note.

Krackow, Kenneth A.; Thomas, Stephen C.; Jones, Lynne C.

doi:10.2106/00004623-198668050-00020

Cited by 340 publications

(209 citation statements)

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“…Experiments with the tendon of beagle dogs showed similar levels of failure with three difference methods of fixation [11,27,28], with the grafts always failing at the interface between the tendon and the fixation material.…”

Section: Discussionmentioning

confidence: 85%

Effects of aggressive early rehabilitation on the outcome of anterior cruciate ligament reconstruction with multi-strand semitendinosus tendon

Muneta

Sekiya

Ogiuchi

et al. 1998

International Orthopaedics

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Section: Discussionmentioning

confidence: 85%

Effects of aggressive early rehabilitation on the outcome of anterior cruciate ligament reconstruction with multi-strand semitendinosus tendon

Muneta

Sekiya

Ogiuchi

et al. 1998

International Orthopaedics

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“…Two Number 5 Ethibond TM (Ethicon Inc, Somerville NJ, USA) sutures were woven into the patellar tendon using the suture technique described by Krackow et al [18]. Three vertical transosseous bone tunnels were made in the patella using a 2.5-mm drill bit.…”

Section: Control Repair Techniquementioning

confidence: 99%

Novel Augmentation Technique for Patellar Tendon Repair Improves Strength and Decreases Gap Formation: A Cadaveric Study

Black

Ricci

Gardner

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background Patellar tendon ruptures commonly are repaired using transosseous patellar drill tunnels with modified-Krackow sutures in the patellar tendon. This simple suture technique has been associated with failure rates and poor clinical outcomes in a modest proportion of patients. Failure of this repair technique can result from gap formation during loading or a single catastrophic event. Several augmentation techniques have been described to improve the integrity of the repair, but standardized biomechanical evaluation of repair strength among different techniques is lacking. Questions/purposes The purpose of this study was to describe a novel figure-of-eight suture technique to augment traditional fixation and evaluate its biomechanical performance. We hypothesized that the augmentation technique would (1) reduce gap formation during cyclic loading and (2) increase the maximum load to failure. Methods Ten pairs (two male, eight female) of freshfrozen cadaveric knees free of overt disorders or patellar tendon damage were used (average donor age, 76 years; range, 65-87 years). For each pair, one specimen underwent the standard transosseous tunnel suture repair with a modified-Krackow suture technique and the second underwent the standard repair with our experimental augmentation method. Nine pairs were suitable for testing. Each specimen underwent cyclic loading while continuously measuring gap formation across the repair. At the completion of cyclic loading, load to failure testing was performed. Results A difference in gap formation and mean load to failure was seen in favor of the augmentation technique. At 250 cycles, a 68% increase in gap formation was seen for the control group (control: 5.96 ± 0.86 mm [95% CI, 5.30-6.62 mm]; augmentation: 3.55 ± 0.56 mm [95% CI, 3.12-3.98 mm]; p = 0.02). The mean load to failure was 13% greater in the augmentation group (control: 899.57 ± 96.94 N [95% CI, 825.06-974.09 N]; augmentation: 1030 augmentation: .70 ± 122.41 N [95% CI, 936.61-1124; p = 0.01). Conclusions This biomechanical study showed improved performance of a novel augmentation technique compared with the standard repair, in terms of reduced gap formation during cyclic loading and increased maximum load to failure. Clinical Relevance Decreased gap formation and higher load to failure may improve healing potential and minimize failure risk. This study shows a potential biomechanical advantage of the augmentation technique, providing support for future clinical investigations comparing this

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“…1). The Krackow stitch [11], performed with five locking loops along each side of the tendon, was set as the control group. A Number 2 FiberWire 1 suture (Arthrex, Naples, FL, USA) was used for each suture-tendon construct.…”

Section: Methodsmentioning

confidence: 99%

“…The whipstitch is a common suture technique for preparing and fixing tendon grafts [14]. Krackow et al [11] proposed an alternative locking suture in 1986, which became a common technique for preparing a suture-tendon graft.…”

Section: Introductionmentioning

confidence: 99%

Do Needleless Knots have Similar Strength as the Krackow Suture? An In Vitro Porcine Tendon Study

Hong

Kuo

Yeh

et al. 2017

Clinical Orthopaedics &Amp; Related Research

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Background Numerous needleless techniques for tendon graft fixation that feature several advantages have been reported. However, there are few studies that have compared the holding strength between the needleless techniques (rolling hitch and modified rolling hitch) and traditional suture methods. Questions/purposes To compare the tendon graft-holding strength of the rolling hitch and modified rolling hitch with the Krackow stitch in an in vitro porcine biomechanical model. Methods Thirty fresh-frozen porcine flexor profundus tendons were randomly divided into three groups of 10 specimens. The experimental procedure was designed to assess elongation of the suture-tendon construct across the needleless tendon-grasping techniques and the Krackow stitch. All suture configurations were completed with a braided nonabsorbable suture. Each tendon was pretensioned to 100 N for three cycles, cyclically loaded from 50 to 200 N for 200 cycles, and then finally loaded to failure. Elongation, load to failure, and mode of failure were recorded for each specimen.

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A new stitch for ligament-tendon fixation. Brief note.

Cited by 340 publications

References 0 publications

Effects of aggressive early rehabilitation on the outcome of anterior cruciate ligament reconstruction with multi-strand semitendinosus tendon

Effects of aggressive early rehabilitation on the outcome of anterior cruciate ligament reconstruction with multi-strand semitendinosus tendon

Novel Augmentation Technique for Patellar Tendon Repair Improves Strength and Decreases Gap Formation: A Cadaveric Study

Do Needleless Knots have Similar Strength as the Krackow Suture? An In Vitro Porcine Tendon Study

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