Dataset Information

High-Strength Suture Tapes Are Biomechanically Stronger Than High-Strength Sutures Used in Rotator Cuff Repair.

ABSTRACT:

Purpose

To assess the mechanical properties, tendon resistance to suture cutout, and knot size of a broad variety of high-strength sutures and tapes available for arthroscopic rotator cuff repair.

Methods

Nine different types of high-strength sutures and tapes for arthroscopic rotator cuff repair were studied: 6 were tapes (FiberTape, Hi-Fi Tape, Permatape, SutureTape, UltraTape, and XBraid TT), and 3 were sutures (Dynacord, FiberWire, and Ultrabraid). First, mechanical tensile testing of suture loops (n = 6) was performed. Second, the suture material was passed through an intact human cadaveric rotator cuff tendon (supraspinatus or infraspinatus), and cyclic as well as load-to-failure testing was performed, 8 times for each suture or tape. Statistical analysis of groups (tapes vs sutures) and between each suture and each tape was performed.

Results

Material testing revealed significant differences with superior mechanical properties of tapes compared with sutures regarding load for 3 mm of displacement (201 N vs 84 N, P < .0001), displacement at 200 N (3.6 mm vs 6.6 mm, P < .0001), stiffness (46 N/mm vs 25 N/mm, P < .0001), and ultimate load to failure (509 N vs 288 N, P < .0001). FiberTape showed the highest ultimate load to failure (805.5 ± 36.1 N), the highest load necessary for 3 mm of displacement (376.2 ± 19.1 N), and the lowest displacement at a 200-N load (2 ± 0.1 mm). Permatape had the highest stiffness (58.5 ± 5.3 N/mm). FiberTape had the highest knot height (9.5 ± 1.3 mm) and knot width (3.8 ± 0.7 mm) of a suture loop with 7 square knots. The typical failure mode in the cadaveric study part was tendon cut through.

Conclusions

Biomechanical in vitro testing showed that high-strength suture tapes compared with regular high-strength sutures have significantly better mechanical properties in both dry-laboratory testing and human cadaveric rotator cuff tendon pullout testing. FiberTape outperformed the other tapes and the sutures used in this analysis. Nonetheless, differences in tendon testing appeared to be less substantial than in dry-laboratory testing, and FiberTape had the highest knot height and width.

Clinical relevance

FiberTape revealed the most favorable biomechanical performance in dry-laboratory and rotator cuff tendon testing. It may provide the best repair strength in vivo; however, it also has the largest knot size.

SUBMITTER: Borbas P

PROVIDER: S-EPMC8220614 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:PurposeTo evaluate the effect of magnesium on cellular adhesion and proliferation of human subacromial bursal tissue (SBT), osteoblasts, and tenocytes on nonabsorbable suture tape commonly used in rotator cuff surgery.MethodsHuman SBT cells, primary human osteoblasts (HOBs), and primary human tenocytes were isolated from tissue samples and cultured in growth media. Commercially available collagen-coated nonabsorbable suture tape was cut into one-inch pieces, placed into 48-well culture dishes, sterilized under ultraviolet light, and treated with (+) or without (-) magnesium. For the (+) magnesium group, a one-time dose of 5 mM sterile magnesium chloride was added. Subsequently, cells were plated at a density of 20,000 cells/cm2. For each cell source (SBT, HOBs, tenocytes) cellular proliferation and adhesion assays on suture tape treated (+) or (-) magnesium were performed.ResultsSBT, HOBs, and tenocytes each demonstrated the ability to adhere and proliferate on suture tape. Augmenting suture tape with magnesium resulted in a significantly increased cellular adhesion of SBT compared with nonaugmented sutures (P = .001), whereas no significant differences were observed for HOBs (P = .081) and tenocytes (P = .907). Augmentation with magnesium demonstrated no significant difference in cellular proliferation of SBT (P = .856), HOBs (P = .672), and tenocytes (P = .251) compared with nonaugmented sutures.ConclusionsSBT, osteoblasts, and tenocytes each demonstrated the ability to adhere and proliferate on suture tape. In addition, augmenting the suture with magnesium resulted in a significantly increased cellular adhesion of SBT compared with nonaugmented sutures, whereas no significant differences were observed for osteoblasts and tenocytes. Further, magnesium did not impair the proliferative activity of SBT, osteoblasts, and tenocytes on suture tape used in rotator cuff surgery.Clinical relevanceModifying the surface of the suture used for repair with application of magnesium may be an inexpensive and technically feasible option to improve the use of SBT for biologic augmentation of rotator cuff repair.