Behavior of sutures used in anterior cruciate ligament reconstructive surgery

This study was performed to determine the material properties of sutures commonly used in orthopedic surgery in order to allow selection of the most appropriate one for securing a hamstring or quadriceps tendon graft in anterior cruciate ligament (ACL) reconstruction. Three suture materials (number 5 Ticron, number 5 Ethibond, and 5 mm Mersilene tape) were tested. The ultimate tensile load (UTL) with and without a knot, modulus of elasticity, effect of conditioning on the behavior of the suture, and plastic deformation were determined for each suture. Prior conditioning significantly improved the plastic deformation characteristics of all three sutures. Mersilene possessed the highest UTL both with and without knots, and its plastic deformation was significantly lower than that of Ticron or Ethibond. We feel that these characteristics make it the best suture for use in securing hamstring or tendon grafts in ACL surgery. Because of the high UTL achieved by Mersilene tape in the knotted surgical loop construct (nearly 500 N), it may be possible to achieve fixation integrity approaching that of interference fixation with bone blocks.