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Updated: Nov 9, 2025
A Novel Tenorrhaphy Suture Technique with Tissue Engineered Collagen Graft to Repair Large Tendon Defects
Published on: December 10, 2021
A novel and efficient surgical knotting technique for high-tension closures
Yongyun Chang1,2, Degang Yu1, Liao Wang1
1Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Background:
The closure of high-tension incisions without any assistance can be difficult and challenging for surgeons. A common practice is to fix the first knot with a clamp and then tie a reverse locking knot; however, this practice has certain disadvantages. The aim of this study was to introduce a novel and efficient surgical knotting technique with various advantages.
Methods:
The two knotting methods used in this study were the absorbable braided suture where the first suture was fixed with a clamp (with assistance) and the SH-9Hospital knotting technique (without assistance) applied on the smooth surface of a cylinder. Mechanical testing was performed using a universal material testing machine. The load-elongation curve and ultimate tensile load (UTL) were recorded.
Results:
The mean knotting time was 36.40±1.50 s (range, 32-41 s) and 24.80±1.16 s (range, 21-28 s) in the clamp and SH-9Hosptial groups, respectively. The mean UTL was 120.8±10.14 N (range, 81.11-136.55 N)and 126.5±6.29 N (range, 104.88-139.56 N) in the clamp and SH-9Hospital groups, respectively. The knot strength of the SH-9Hospital technique was not inferior to traditional clinical practice.
Conclusions:
The SH-9Hospital knotting technique was a secure, convenient, and efficient method for high-tension closure.
