Polytetrafluoroethylene (PTFE) suture vs fiberwire and polypropylene in flexor tendon repair

Elias Polykandriotis,Ektor Polykandriotis,Andreas Arkudas,Lars Bräuer,Jasmin S Gruener,Raymund E Horch,Miriam Niederkorn,Florian Ruppe

doi:10.1007/s00402-021-03899-9

Abstract

BackgroundIn this study, we evaluate the value of novel suture material based on monofilamentous-extruded polyfluoroethylene (PTFE) compared to polypropylene (PPL) and Fiberwire (FW).Materials and methods60 flexor tendons were harvested from fresh cadaveric upper extremities. 4–0 sutures strands were used in the PPL, FW and PTFE group. Knotting properties and mechanical characteristics of the suture materials were evaluated. A 4-strand locked cruciate (Adelaide) or a 6-strand (M-Tang) suture technique was applied as core sutures for a tendon repair. Two-way ANOVA tests were performed with the Bonferroni correction.ResultsStable knotting was achieved with 5 throws with the PPL material, 7 throws for FW and 9 throws for PTFE. In the PPL group, linear tensile strength was 45.92 ± 12.53 N, in the FW group 80.11 ± 18.34 N and in the PTFE group 76.16 ± 29.10 N. FW and PTFE are significantly stronger than PPL but show no significant difference among each other. Similar results were obtained in the subgroup comparisons for different repair techniques. The Adelaide and the M-Tang knotting technique showed no significant difference.ConclusionFiberwire showed superior handling and knotting properties in comparison to PTFE. However, PTFE allows easier approximation of the stumps. In both, M-Tang and Adelaide repairs, PTFE was equal to FW in terms of repair strength. Both PTFE and FW provide for a robust tendon repair so that early active motion regimens for rehabilitation can be applied.

Highlights

There is a plethora of evidence stating that early active motion promotes tendon healing and diminishes adhesions after flexor tendon repair [1, 2]
Fiberwire® (Arthrex Inc, Naples, FL, USA) is a polyblend strand. It is composed of a multi-strand, long-chain ultra-high molecular weight polyethylene (UHMWPE) core with a braided jacket of polyester and UHMWPE
Knotted FW broke at 23.95 ± 3.920 N and PTFE had a linear tensile strength of 21.57 ± 0.773

Summary

Introduction

There is a plethora of evidence stating that early active motion promotes tendon healing and diminishes adhesions after flexor tendon repair [1, 2]. We evaluate the value of novel suture material based on monofilamentous-extruded polyfluoroethylene (PTFE) compared to polypropylene (PPL) and Fiberwire (FW). A 4-strand locked cruciate (Adelaide) or a 6-strand (M-Tang) suture technique was applied as core sutures for a tendon repair. Results Stable knotting was achieved with 5 throws with the PPL material, 7 throws for FW and 9 throws for PTFE. The Adelaide and the M-Tang knotting technique showed no significant difference. M-Tang and Adelaide repairs, PTFE was equal to FW in terms of repair strength. Both PTFE and FW provide for a robust tendon repair so that early active motion regimens for rehabilitation can be applied

Methods

Results

Conclusion