The Biomechanical Properties of a High-Tensile Strength Tape for Tendon Graft Fixation Using the Krackow Configuration

Hong, Chih-Kai; Hsu, Kai-Lan; Kuan, Fa-Chuan; Chen, Yueh; Chiang, Chen‐Hao; Yeh, Ming Long; Wen, Miin-Jye; Su, Wei-Ren

doi:10.1016/j.asmr.2020.05.002

Cited by 3 publications

(8 citation statements)

References 25 publications

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“…The present study further investigated the biomechanical properties of the round suture and tape in arthroscopic sliding knots and demonstrated greater clinical failure loads in the tape samples than in the round suture samples. These findings are consistent with the reports of prior works 7 , 10 and support the use of tapes in arthroscopic surgeries.…”

Section: Discussionsupporting

confidence: 92%

“…They also indicated that high-strength tape showed superior knot security with minimal slippage compared with high-strength round sutures even though the average knot stack height for both tape and round sutures was comparable. 10 Hong et al 7 compared the No. 2 high-strength round suture and 1.3-mm high-strength tape applied for tendon graft fixation using a Krackow configuration and found a greater ultimate failure load in the high-strength tape group.…”

Section: Discussionmentioning

confidence: 99%

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Knots Tied With High–Tensile Strength Tape Biomechanically Outperform Knots Tied With Round Suture

Hong

Chuang

Hsu

et al. 2021

Orthopaedic Journal of Sports Medicine

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Background: Tape-type suture material is well-accepted in arthroscopy surgery. Purpose: To compare the knot security of a high–tensile strength round suture and high–tensile strength tape with commonly used arthroscopic knots. Study Design: Controlled laboratory study. Methods: We compared the performance of No. 2 braided nonabsorbable high-strength suture with that of 1.3-mm braided nonabsorbable high-strength tape. Five commonly used arthroscopic knots were investigated: the Roeder knot; the Western knot; the Samsung Medical Center (SMC) knot; the Tennessee knot; and a static surgeon’s knot. Seven knots were tied for each combination of knots and suture types. Knots were tied on a 30-mm circumferential metal post, and the suture loops were transferred to a materials testing machine. After preloading to 5 N, all specimens were loaded to failure. The clinical failure load, defined as the maximal force to failure at 3 mm of crosshead displacement, yield load, and stiffness, were recorded. A 2-way analysis of variance was used to determine differences between the groups. Results: Both suture type and knot type significantly affected the clinical failure load, yield load, and stiffness ( P = .002). The high-strength tape resulted in a significantly greater clinical failure load than the high-strength suture in the case of the Roeder knot, Western knot, and SMC knot ( P = .027, .005, and .016, respectively). When the high-strength round suture was used, the Roeder knot, Western knot, and SMC knot resulted in significantly smaller clinical failure loads compared with the Tennessee knot ( P = .011, .003, and .035, respectively) and the static surgeon’s knot ( P < .001 for all). When the high-strength tape was used, the Roeder knot, Western knot, and SMC knot resulted in significantly smaller clinical failure loads compared with the static surgeon’s knot ( P = .001, .001, and .003, respectively). Conclusion: The results of this study indicated that arthroscopic knots tied using 1.3-mm high-strength tape biomechanically outperformed knots tied using a No. 2 high-strength suture. While the static surgeon’s knot exhibited the best biomechanical properties, the Tennessee knot resulted in generally better biomechanical properties among the arthroscopic sliding knots. Clinical Relevance: Elongation and loosening of tied knots possibly affects the clinical results of repaired constructs.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Knots Tied With High–Tensile Strength Tape Biomechanically Outperform Knots Tied With Round Suture

Hong

Chuang

Hsu

et al. 2021

Orthopaedic Journal of Sports Medicine

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“…[10][11][12] On the other hand, tapetype sutures were developed to prevent sutures from pulling through the tendons and were believed to provide greater tendon graft fixation strength compared to round-shaped sutures. [17][18][19] However, it remains unclear whether tapetype sutures can provide superior biomechanical properties in tendon graft fixation using needleless suture wrapping techniques. The present study then further investigated the use of tape-type suture in tendon graft fixation using needleless suture wrapping techniques.…”

Section: Discussionmentioning

confidence: 99%

“…The biomechanical testing parameters and testing protocol were in accordance with those used in previous studies. 2,6,12,15,16,19,21,23,26,27 Initially, three cycles of pretensioning force ranging from 0 to 100 N at a rate of 100 mm/min were conducted. After preloading to 50 N for 1 minute, each specimen was cyclically loaded between 50 and 200 N with a cross-head speed of 200 mm/min for 200 cycles.…”

Section: Methodsmentioning

confidence: 99%

“…The previous studies have suggested several suture wrapping techniques to be attractive options in tendon graft fixation with braided nonabsorbable high-strength sutures. Although using tape-type sutures in tendon graft fixation with specific suture techniques may lead to greater tendon graft fixation strength, [17][18][19] it remains unclear whether tape-type sutures have superior biomechanical properties to round sutures in tendon graft fixation using needleless suture wrapping techniques.…”

Section: Introductionmentioning

confidence: 99%

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Does using high-tensile strength tape improve the fixation strength in tendon graft fixation with needleless suture wrapping techniques compared to a suture?

Hong

Kuan

Hsu

et al. 2020

J Orthop Surg (Hong Kong)

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Purpose: To compare the biomechanical properties of a high-tensile strength suture and high-tensile strength tape in tendon graft fixation using two needleless suture wrapping techniques, the modified Prusik knot and modified rolling hitch. Methods: Two needleless suture wrapping techniques, the modified rolling hitch (MR) and modified Prusik knot (MP), were utilized. Meanwhile, two kinds of suture materials, a No. 2 braided nonabsorbable high-strength suture (S) and a 1.3 mm high-tensile strength tape (T), were used. A total of 40 porcine tendons were used, which were randomly divided into four groups. Each group was assigned to one of the following groups: MRS, MRT, MPS, and MPT. Each specimen was pretensioned to 100 N for three cycles, cyclically loaded from 50 to 200 N for 200 cycles, and finally loaded to failure. Results: The MRT group (34.1 ± 3.5%) had a significantly higher value compared with the MRS (29.7 ± 2.3%), MPS (27.1 ± 3.6%) and MPT (29.5 ± 4.0%) groups in term of elongation after cyclic loadings ( p = 0.002). In terms of ultimate failure load, there were no significant differences in the MRS (401 ± 27 N), MRT (380 ± 27 N), MPS (398 ± 44 N) and MPT (406 ± 49 N) values ( p = 0.539). All specimens failed due to suture breakage at the knots. Conclusion: Compared with the high-tensile strength suture, using the high-tensile strength tape lead to greater elongation after cyclic loading when the modified rolling hitch was used. No differences in terms of elongation after cyclic loading and load to failure were found between the high-tensile strength suture and tape using the modified Prusik knot.

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Ligament Augmentation Reconstruction System (LARS) for Ankle Lateral Ligament Reconstruction in Higher-Risk Patients: A 5-Year Prospective Cohort Study

Porter

Trajkovska

Georgousopoulou

2022

Orthopaedic Journal of Sports Medicine

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Background: The modified Broström-Gould (MBG) procedure is the gold standard for patients with chronic ankle instability (CAI), but it is relatively contraindicated for patients with higher body weight or generalized ligamentous laxity (GLL). The use of the ligament augmentation reconstruction system (LARS) is an alternative. Hypothesis: It was hypothesized that clinical outcomes would be similar in patients with increased body weight (>90 kg) or GLL, relative to controls. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 66 patients satisfying the inclusion criteria were invited to participate and were divided into 3 groups: controls (no risk factors for inferior clinical outcome), patients with body weight >90 kg, and patients with GLL (Beighton score, ≥5 of 9). All patients underwent imbrication of the lateral collateral ligament complex augmented with the LARS. Primary outcomes of interest were Tegner activity scale (TAS) and Foot and Ankle Outcome Score (FAOS) subscale scores. Secondary outcomes were recurrence of ankle instability, the need for further surgery, and/or complications. Patients were reviewed at 2 and 5 years postoperatively, and outcomes between groups were compared using repeated-measures analysis of variance. Results: Complete data were available for 63 patients (21 patients in each group). TAS improved in all groups from preoperatively to 2 years and 5 years postoperatively ( P < .001 for all). Relative to the controls, the TAS scores were lower in the >90-kg group at 2 years and 5 years ( P < .001 for both periods), while the GLL group had similar scores to controls at both postoperative periods. Both the >90-kg and the GLL groups showed no significant difference in improvement on any FAOS subscale scores relative to the controls, at both 2 and 5 years postoperatively. There were no recurrences, repeat surgeries, or major complications. Conclusion: Relative to controls, patients with body weight >90 kg or GLL had similar FAOSs, and TAS scores were lower in the >90-kg group, at 2 and 5 years, after the use of the LARS to augment lateral collateral ligament imbrication for CAI. Use of the LARS in this manner is a viable option in patients for whom the MBG procedure is relatively contraindicated.

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The Biomechanical Properties of a High-Tensile Strength Tape for Tendon Graft Fixation Using the Krackow Configuration

Cited by 3 publications

References 25 publications

Knots Tied With High–Tensile Strength Tape Biomechanically Outperform Knots Tied With Round Suture

Knots Tied With High–Tensile Strength Tape Biomechanically Outperform Knots Tied With Round Suture

Does using high-tensile strength tape improve the fixation strength in tendon graft fixation with needleless suture wrapping techniques compared to a suture?

Ligament Augmentation Reconstruction System (LARS) for Ankle Lateral Ligament Reconstruction in Higher-Risk Patients: A 5-Year Prospective Cohort Study

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