Traditional suture tape versus multiple high-strength sutures for augmentation of anterior cruciate ligament primary repair: A time-zero biomechanical study

Thun Itthipanichpong; Puchong Kulrat; Danaithep Limskul; Thanathep Tanpowpong; Chanyaphan Virulsri; Pairat Tangpornprasert; Somsak Kuptniratsaikul; Napatpong Thamrongskulsiri

doi:10.1016/j.asmart.2023.11.007

Traditional suture tape versus multiple high-strength sutures for augmentation of anterior cruciate ligament primary repair: A time-zero biomechanical study

Asia Pac J Sports Med Arthrosc Rehabil Technol. 2023 Dec 8:35:39-42. doi: 10.1016/j.asmart.2023.11.007. eCollection 2024 Jan.

Authors

Thun Itthipanichpong¹, Puchong Kulrat¹, Danaithep Limskul¹, Thanathep Tanpowpong¹, Chanyaphan Virulsri², Pairat Tangpornprasert², Somsak Kuptniratsaikul¹, Napatpong Thamrongskulsiri³

Affiliations

¹ Department of Orthopaedics, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand.
² Center of Excellence for Prosthetic and Orthopedic Implant, Department of Mechanical Engineering, Faculty of Engineering, Chulalongkorn University, Bangkok, Thailand.
³ Department of Anatomy, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

Abstract

Background/objective: During the initial stages of rehabilitation after anterior cruciate ligament (ACL) surgery, a pivotal role is played in ensuring effective recuperation and averting complications. An often-employed strategy to tackle ACL laxity during this period involves the incorporation of synthetic materials for reinforcement. The objective of this study is to compare the effectiveness of conventional suture tape and multiple high-strength sutures as augmentation techniques for ACL repair.

Methods: Ten preserved cadaveric knees embalmed using the Thiel method were segregated into two groups, each containing five knees. In one group, traditional suture tape was employed for augmentation, while the other group utilized multiple high-strength sutures. Each knee underwent a cyclic load of 1000 sine wave cycles, succeeded by an axial distraction load until failure ensued. The resultant displacement and ultimate load at failure were assessed to contrast the efficacy of the two augmentation techniques.

Results: The group utilizing multiple high-strength sutures exhibited a significantly higher load to failure at time-zero (1690.7 N) compared to the suture tape group (987.6 N) (P = .003). Furthermore, the multiple high-strength sutures group demonstrated significantly reduced displacement after 1000 cyclic loads (6.6 mm) in comparison to the suture tape group (16.3 mm) (P < .001).

Conclusions: Multiple high-strength sutures show better biomechanical properties for the augmentation of ACL repair at time-zero. Both suture tape and multiple high-strength sutures had ultimate load-to-failure values higher than the natural ACL loads. Therefore, these substances might serve as augmentation options to prevent the ACL's gradual elongation, a critical concern particularly in the initial stages of rehabilitation.

Keywords: Anterior cruciate ligament repair; High-strength suture; Internal brace; Suture tape; Synthetic augmentation.