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Strength of damaged suture: an in vitro study
Patrick B Wright1, Jeffrey E Budoff, Ming Long Yeh
1Department of Orthopaedic Surgery, Baylor College of Medicine, Houston, Texas 77030, USA.
Summary
Newer polyethylene core sutures like FiberWire and Orthocord show superior mechanical strength, even when damaged. Polydioxanone (PDS) suture loses significant strength when cut, unlike these advanced materials.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
- Surgical Device Engineering
Background:
- Suture mechanical properties are critical for arthroscopic procedures.
- Understanding how suture damage affects performance is essential for surgical success.
Purpose of the Study:
- To evaluate and compare the mechanical properties of various sutures in both undamaged and damaged states.
- To assess the impact of cutting and passing sutures through anchors on their load to failure and ultimate tensile strength.
Main Methods:
- Sutures were subjected to a single pull-to-failure test.
- Damage was induced using a razor blade in a custom jig.
- Testing included straight pull and 180-degree pull through a suture anchor eyelet.
- Friction through anchors was also quantified.
Main Results:
- FiberWire and Orthocord demonstrated the highest load to failure (LTF) and ultimate tensile strength (UTS) in straight pull tests, both undamaged and damaged.
- When cut, FiberWire and Orthocord maintained significantly higher LTF and UTS compared to other sutures.
- Polydioxanone (PDS) suture exhibited the greatest loss in LTF and UTS after being cut, especially during the suture anchor test.
Conclusions:
- Advanced polyethylene core sutures (FiberWire, Orthocord) possess superior mechanical integrity, which is largely preserved after damage.
- While uncut PDS may offer comparable strength to some traditional sutures, its mechanical properties degrade substantially upon cutting.
- These findings highlight the importance of material selection for arthroscopic surgery, particularly concerning suture integrity under stress and damage.
