Knots Tied With High–Tensile Strength Tape Biomechanically Outperform Knots Tied With Round Suture. Issue 10 (5th October 2021)

• Record Type: Journal Article
• Authors: Hong, Chih-Kai; Chuang, Hao-Chun; Hsu, Kai-Lan; Kuan, Fa-Chuan; Chen, Yueh; Yeh, Ming-Long; Su, Wei-Ren
• Is Part Of: Orthopaedic journal of sports medicine. Volume 9:Issue 10(2021)
• Publication Date: 2021-10-05
• Subjects: arthroscopy -- knot -- high-strength suture -- high-strength tape -- biomechanical; Sports medicine -- Periodicals; Orthopedics -- Periodicals; Arthroscopy -- Periodicals; Arthroplasty -- Periodicals; Knee -- Surgery -- Periodicals; 616.7
• DOI: 10.1177/23259671211039554
• Languages: English
• ISSNs: 2325-9671

Abstract

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.