Knot and Loop Security of High-Strength Suture Tape vs. High-Strength Suture Wire

Abstract

To evaluate knot security, loop security, and knot size of suture tape and suture wire. The single load to failure (LTF) and cyclic loading of one arthroscopic knot (Samsung Medical Center [SMC]) and one hand-tied knot (surgeon’s knot) using two suture tapes (Broadband-[BB], Suture Tape-[ST]) and two No. 2 suture wires (MaxBraid-[MB], FiberWire-[FW]). A third tape (FiberTape-[FT]), not commonly tied arthroscopically, was included in the hand-tied group. Ten samples for each suture-knot combination were evaluated for knot security, loop security, and knot volume. Data were compared with analysis of variance and the Tukey post-hoc test and considered significant at P < 0.05. In single LTF testing, FT was stronger than any other suture-knot configuration. With surgeon’s knots, BB was stronger than MB and FW, while ST was superior to FW. With cyclic loading, BB and ST had less cyclic elongation than MB and FT in the hand-tied group. Among surgeon’s knots, loop elongation was smallest in BB. FT had the largest loop elongation among all configurations. No significant differences detected among SMC-knot configurations in single LTF, cyclic testing, and loop elongation. Measuring hand-tied knots, FW had greater knot volume than BB and ST, and MB was larger than ST. Excluding FT, surgeon’s knots were smaller than SMC-knots. Among SMC-knots, BB was bulkier than ST and MB. FT had largest knots overall. FT had the best knot security, but the poorest loop security and largest knot volume. With surgeon’s knots, BB had better knot security than both suture wires; ST also bested FW. Hand-tied BB, ST, and MB knots were stronger than their SMC-knot counterparts. BB demonstrated the best loop security among hand-tied knots; no differences were seen between surgeon’s and SMC-knots. Thinner tape designs (BB, ST) had smaller knots than wire designs when tied with surgeon’s knots, but not with SMC-knots.