Braided Polyester Suture Research Articles

Benefits of Rib Fixation Utilizing Low-Cost Materials: A Randomized Pilot Trial

IntroductionSurgical stabilization of rib fractures (SSRF) using standard rib plating systems has become a norm in developed countries. However, the procedure has not garnered much interest in low–middle-income countries, primarily because of the cost. MethodsThis was a single-center pilot randomized trial. Patients with severe rib fractures were randomized into two groups: SSRF and nonoperative management. SSRF arm patients underwent surgical fixation in addition to the tenets of nonoperative management. Low-cost materials like stainless steel wires and braided polyester sutures were used for fracture fixation. The primary outcome was to assess the duration of hospital stay. ResultsTwenty-two patients were randomized, 11 in each arm. Per-protocol analysis showed that the SSRF arm had significantly reduced duration of hospital stay (22.6 ± 19.1 d versus 7.9 ± 5.7 d, P value 0.031), serial pain scores at 48 h and 5 d (median score 5, IQR (3-6) versus median score 7, IQR (6.5-8), P value 0.004 at 48 h and median score 2 IQR (2-3) versus median score 7 IQR (4.5-7) P value 0.0005 at 5 d), significantly reduced need for injectable opioids (9.9 ± 3.8 mg versus 4.4 ± 3.4 mg, P value 0.003) and significantly more ventilator-free days (19.9 ± 8.7 d versus 26.4 ± 3.2 d, P value 0.04). There were no statistically significant differences in the total duration of ICU stay (median number of days 2, IQR 1-4.5 versus median number of days 7, IQR 1-14, P value 0.958), need for tracheostomy (36.4% versus 0%, P value 0.155), and pulmonary and pleural complications. ConclusionsSSRF with low-cost materials may provide benefits similar to standard rib plating systems and can be used safely in resource-poor settings.

Sling for the sling: a new technique for long-term correction of severe congenital ptosis

IntroductionSevere congenital ptosis poses a complex challenge for oculoplastic surgeons, requiring meticulous surgical intervention to restore eyelid function and improve aesthetic outcomes mainly by using frontalis sling approach. A crucial issue in frontalis sling surgeries is the sustainability of effect.PurposeThis retrospective study reports the outcomes of two surgical techniques for treating severe congenital ptosis in the paediatric age group: Silicon rods ptosis sling and a novel technique involving the use of Silicon rods with green braided polyester (Ethibond) sutures to secure the rods in place “sling for the sling”.MethodsThe medical records of children who underwent frontalis suspension were reviewed in a retrospective fashion. We identified two groups; the first group (20 patients: 35 eyelids) had the traditional frontalis suspension surgery using silicone suspension set, the second group (14 patients: 25 eyelids) was operated using the new “sling for sling” technique. We used the postoperative marginal reflex distance-1 (MRD-1) as the primary outcome measure while the frequency of both wound related complications and recurrence were considered as secondary outcome measures. Post operative data were collected and compared after 1 month, 6 months, 12 months, and 18 months.ResultsPreliminary results indicate promising outcomes for both techniques, with significant improvement in eyelid elevation observed in both groups. However, the novel technique using Silicon rods with Ethibond sutures demonstrated enhanced sustainability, leading to a more durable outcome with significantly less recurrence.ConclusionThis study highlights the potential benefits of the novel technique in treating severe congenital ptosis and introduces an innovative approach to Silicone rods fixation to achieve a long-term corrective effect.

Anterior Cruciate Ligament Reconstruction Using Hamstring Graft with and without Suture Augmentation: A Randomized Trial

Background: The anterior cruciate ligament (ACL) is a vital knee joint stabilizer with rising injury rates. Anatomic ACL reconstruction (ACLR) aims to restore the ACL to its original dimensions, collagen orientation, and insertion sites, but complete restoration may not be possible. Suture augmentation (SA) involves the use of autologous hamstring tendons with a braided ultrahigh molecular weight polyester or polyethylene (UHMWPE) suture or suture tape to act as a secondary stabilizer until complete integration. This study aimed to compare the outcomes of ACLR using hamstring grafts with and without SA.
 Methods: This trial was conducted at a tertiary-level health care center, with 50 patients divided randomly into two groups: 25 patients for standard ACLR (group A) and 25 patients for ACLR with SA (group B). Participants provided informed consent. Baseline clinical characteristics including range of motion (ROM), pain [Numeric Pain Rating Scale (NPRS)], and functional outcomes [Lysholm and International Knee Documentation Committee (IKDC) scores] were collected.
 Results: The mean age was 25.5 years, with 96% male and 4% female participants. A statistically significant improvement was found in both groups in ROM, NPRS scores, and functional outcomes at 1 and 6 months. There was no significant difference in both groups regarding the IKDC score. Lysholm’s score showed a remarkable improvement in both groups.
 Conclusion: SA could be an effective technique for ACLR, with comparable outcomes to standard ACLR.

Mechanical performances of double layer braided polyester sutures intended for orthopedic surgery

Mechanical performances of double layer braided polyester sutures intended for orthopedic surgery

Addition of Transfixation Suture to Purse String Suture During Intraperitoneal Inguinal Hernia Repair Increases Peri-Hernia Sac Neck Collagen Formation

BackgroundThe worldwide accepted repair for indirect inguinal hernia in children is high ligation of the hernia sac with open herniotomy. However, laparoscopic pediatric inguinal hernia repair (IHR) has been gaining popularity in the last two decades. An experimental study was conducted to investigate the effects of different intraperitoneal IHR suture techniques on the collagen formation at the hernia sac neck. MethodsPresent study was conducted on thirty-five male adult (3–6 months old) Wistar-Albino rats (260–300 g). Intraperitoneal IHR with different hernia sac neck suturing techniques (purse string suture only, transfixation suture only and purse string suture plus transfixation suture) were performed through median laparotomy using open operative techniques. Non-absorbable 2/0 braided polyester suture with 16 mm 1/2 curved round needle (Ti-cron, Covidien, MN) was used as suture material. ResultsThe highest collagen thickness around the suture was detected in intraperitoneal IHR with purse-string plus transfixation suture group. The collagen thickness of the intraperitoneal IHR with purse string suture only and IHR with tranfixation suture only groups were not statistically significantly different. The collagen thickness of the intraperitoneal IHR with purse string suture plus transfixation suture group was statistically significantly higher compared with the intraperitoneal IHR with purse string suture only and intraperitoneal IHR with transfixation suture only groups. ConclusionsThe combined usage of purse string suture and transfixation suture during laparoscopic intraperitoneal inguinal hernia repair further stimulates mesothelial fibrosis at the hernia sac neck compared with mesothelial fibrosis induced by purse string suture only or transfixation suture only.

Clinical Equivalence of Trubond® and Ethibond® Braided Polyester Sutures for Valvular Prosthesis Fixation During Aortic or Mitral Valve Replacement: A Single-Blind Randomized Controlled Trial.

Background Paravalvular leak (PVL) following valve replacement is a serious cardiovascular complication that increases morbidity and mortality. Valve replacement with the interrupted suture technique using polyester suture provides adequate tensile strength and reduces the probability of tissue reaction. This study compared the clinical equivalence of Trubond®(Healthium) and Ethibond® (Ethicon, Johnson & Johnson) braided polyester sutures for valvular prosthesis fixation using interrupted suturing, with respect to the proportion of subjects having PVL after aortic valve (AV) or mitral valve (MV) replacement. Methodology Patients undergoing AV/MV replacement were enrolled and randomized in this study. The primary endpoint of this prospective, multicentric, two-arm, randomized (1:1), parallel-group, single-blind study (December 2020-October 2022) was the presence of PVL in Trubond® (n = 40) and Ethibond® (n = 42) groups within 26 weeks of surgery. The secondary endpoints included event rate of all-cause mortality, cardiac death, stroke, myocardial infarction, re-hospitalization, re-intervention, wound infection, operative time, intraoperative suture parameters, postoperative hospital stay, time to resume normal activities and work, quality of life, patient satisfaction, and adverse events in both groups. Results Patients who underwent AV/MV replacement and were followed up until 26 weeks had no incidence of PVL or other postoperative complications. No requirement for readmission or re-intervention was noted in both groups. Intraoperative suture handling characteristics, operative time, and hospital stay were also comparable between the groups. With each follow-up, subjects in both groups exhibited improved postoperative functional abilities, quality of life, and health status. Conclusions Trubond® braided polyester suture is clinically equivalent to Ethibond® braided polyester suture. Trubond® suture is safe and effective for valvular prosthesis fixation in patients undergoing AV or MV replacement.

Evaluation of the treatment of traumatic coxofemoral luxations in dogs using toggle pin technique

This study was performed on 11 dogs diagnosed with traumatic coxofemoral luxation. The direction of the luxations, the operation details, postoperative complications, and radiographic evaluation were recorded during the study. The study utilized the toggle pin technique, which provided open-reduction techniques for the treatment of coxofemoral luxations. Polyester multifilament braided sutures with commercial toggle pins were employed in three cases, whereas toggle pins obtained from Kirschner wire and monofilament nylon suture material were performed in eight patients. Clinical and radiographic monitoring of postoperative lameness, complications, pain, and infection were assessed and recorded for comparison. Postoperative reluxation was observed in two cases in which multifilament braided polyester suture material was performed without other complications. In the cases without reluxation, it was noted that the animals used their limbs comfortably on the 1st postoperative day, and their lameness scores were 0 on the 7th postoperative day. As a result of the findings, the toggle pin technique using monofilament nylon suture could effectively treat coxofemoral luxations in dogs.

Effect of Suture Used for Closure of Mesenteric Defects After Laparoscopic Roux-en-Y Gastric Bypass: Single-Center Study

Small bowel obstruction (SBO) due to internal herniation (IH) is a well-known complication of laparoscopic Roux-en-Y gastric bypass (LRYGBP). The objective of this study is to evaluate different types of non-absorbable sutures used for closure of the defects regarding the incidence of SBO due to IH/adhesions, adhesion formation in general, or reopening of the defects. A single-center retrospective study was performed. Patients who underwent LRYGBP were divided in 3 groups: group A closure of the defects with monofilament Polypropylene suture (Prolene®), group B with braided polyester suture(Ethibond®), group C with barbed knotless Polybutester suture (V-Loc®). Descriptive statistics were performed regarding SBO due to IH/adhesions, adhesion formation, and reopening of closed defects. From5145 patients, 224 patients underwent exploratory laparoscopy for suspicion of SBO. Mean time interval was 28.4months. IH orintermittent IHwas found in 1.94% in group A, 1.78% in group B, and 1.40% in group C. Obstruction due to adhesions was found in 0.70%, 0.36%, and 0.42% per group, respectively. Adhesions in general were observed in 1.47% in group A, 1.43% in group B, and 1.06% in group C. The incidence of reopening was higher in group A (2.24%) in comparison with group B (1.13%, P = 0.041) and group C (1.05%, P = 0.001). After descriptive analysis, these results can withhold no difference among the 3 non-absorbable sutures regarding incidence of SBO due to IH or SBO due to adhesions, yet tendency for higher reopening rates after closure with monofilament Polypropylene suture is observed.

Surgical Management of Traumatic Teat Fistulas in Crossbred Goats with Polyester Sutures

A total of six goats presented to University Veterinary Hospital (UVH), at Omar Al-Mukhtar University, with traumatic teat fistulas were selected for the present study. Upon preoperative evaluation, the mucosal and muscular layers were sutured separately by a simple continuous suture pattern using polyglactin 910. The skin edges were opposed by using braided and polybutilate-coated polyester sutures. Postoperative evaluation of the reconstructed teat was carried out by morphological evaluation and ultrasonographical evaluation. The quality of milk and milk ability reflected the effectiveness of the technique in regaining the functional capacity of the teat postoperatively. The surgical technique employed for the management of teat wounds with fistula was found to be less effective due to the encountered complications which could be due to the management practices, postoperative care, and the suture material.

The most economical arthroscopic suture fixation for tibial intercondylar eminence avulsion fracture without any implant

BackgroundAvulsion fracture of the tibial intercondylar eminence is a rare injury, which mainly occurs in adolescents aged 8–14 years and in those with immature bones. The current commonly used surgery may result in severe surgical trauma, affecting knee joint function and accompanied by serious complications. In this study, we described an all-inside and all-epiphyseal arthroscopic suture fixation technique for a patient to treat tibial intercondylar eminence fracture.MethodsETHIBOND EXCEL-coated braided polyester sutures were used for fixation. Three ETHIBOND sutures were passed through the ACL at 2, 6 and 10 o’clock of the footprint of the ACL and made a cinch-knot loop separately. Under the guidance of ACL tibial locator, three corresponding tibial tunnels were drilled with K-wires at 2, 6 and 10 o’clock of the fracture bed, and the two ends of the suture were pulled out through the tunnel with double-folded steel wire heads. After reduction of the tibial eminence, three sutures were tightened and tied to the medial aspect of the tibial tubercle.ResultsAfter all the surgical treatments surgically performed by this method and following a standard postoperative protocol, our patient's ROM, stability, and functional structural scores all improved significantly.ConclusionThis three-point suture technique provides a suitable reduction and stable fixation and is suitable for patients with all types of avulsion fractures of the tibial intercondylar eminence.

Arthroscopically Assisted Acromioclavicular and Coracoclavicular Reconstruction with a Looped Braided Polyester Suture Band and Buckle Device

Acromioclavicular (AC) joint injuries occur with a traumatic load to the lateral aspect of the shoulder and account for 9% of all shoulder girdle injuries. Rockwood classified AC joint injuries as type I though type VI, based on severity of injury, radiographic findings, and reducibility of the AC joint. Type I and II injuries are typically managed nonoperatively, whereas type IV, V, and VI are managed operatively to address the significant soft tissue disruption, persistent AC joint instability, and apical shoulder deformation. Treatment of type III injuries remain controversial. Several techniques have been described to treat AC joint injuries with no consensus for optimal treatment. “Anatomic” double-tunnel coracoclavicular ligament reconstruction is one currently popular technique to address AC joint injuries; however, clavicle and coracoid fractures are well-described complications of this technique. The objective of this technical report is to describe our preferred technique to address AC joint injuries. This technique involves using a looped braided polyester prosthetic band and low-profile buckle with allograft augmentation using a device to pass materials around the coracoid process.

Technical modification and safe explantation of the Melody valve in the mitral position in small children.

Technical modification and safe explantation of the Melody valve in the mitral position in small children.

490 Sublaminar Sutures for Stabilization and Fusion of a C3-4 Fracture Dislocation in a 11-Month-Old Infant

INTRODUCTION: Pediatric spinal cord injuries (SCI) are an uncommon occurrence with a rate of 1.99 cases per 100,000 children in the United States. Sub-axial SCIs are even rarer and thus, techniques for fixation are limited. Lateral mass screws are not feasible in infants and toddlers due to limited bone volume. We describe a successful stabilization of a C3/4 fracture dislocation in a 3-month-old using sublaminar sutures. METHODS: A standard midline incision and subperiosteal dissection was used to expose C3 to C5. The ligamentum flavum was released and the blunt end of non-absorbable braided polyester sutures were passed under the lamina. Sutures were preferred over wiring due to its tensile properties. In fragile infant bone, sutures are more likely to avoid bony laceration in the lamina, especially during reduction. Sutures were passed in tandem fashion bilaterally, from C2-C4, C3-C5 then C3-C4. Sutures were tied confirming reduction under fluoroscopy. RESULTS: A 3-month-old female after MVC presented with an ASIA-A SCI and a C5 motor level. Imaging revealed a C3-4 fracture-dislocation and right C3 pedicle fracture with cord transection at T1-2. The patient was placed in a c-collar until bony growth of the spine had occurred at 11 months-of-age. The patient then underwent stabilization and fusion as described above. Follow-up x-rays taken 8 months post-operatively revealed adequate bony growth and fusion. CONCLUSION: The literature on management of sub-axial SCIs in infants is sparse. Low bone density in this population limits surgical options for stabilization. We discuss a 3-month-old female with a C3-4 fracture-dislocation who underwent delayed posterior stabilization via sublaminar suturing at 11 months-of-age. The patient achieved successful bony fusion on follow-up imaging without evidence of non-union.

Laparoscopic management of persistent vaginal discharge remote from sacrocolpopexy

Demonstrate surgical management of sinus tract formation from infected suture material. Sacrocolpopexy is considered the "gold standard" by many for the management of advanced pelvic organ prolapse. Adverse outcomes, such as anatomic failure and mesh or suture exposure, have been shown to occur over increased length of time from the index surgery. Given permanent foreign body placement with this reconstructive technique, inflammatory reaction due to infection may result in complication. We present a 60-year-old gravida 4 para 4 with a two-year history of persistent vaginal discharge. Her surgical history is notable for laparoscopic hysterectomy, sacrocolpopexy, midurethral sling, and posterior colporrhaphy 12 years ago, as well as ventral and right inguinal hernias repaired with abdominal mesh 2 years ago. The patient did not have recurrence of prolapse on exam. This case demonstrates management of sinus tract formation from an inflammatory response to infected tissue from permanent polyester braided suture material. The case was begun with intraabdominal survey. The peritonealized mesh was identified, and the distal end was noted to be edematous. Culture results showed a polymicrobial infection. Dissection was performed over the apical mesh. Suture material and involved mesh were identified and resected. Minimal tissue integration into the macropores of the mesh was observed. A vaginotomy was created due to the sinus tract and was repaired with Monocryl suture after bladder dissection. The overlying peritoneum was dissected superiorly, and the mesh was excised until healthy tissue with mesh integration was identified. The peritoneum was reapproximated using barbed suture, and the patient was discharged with a 7-day course of antibiotics. To avoid infectious complications, surgeons may consider avoiding braided polyester suture for vaginal mesh attachment when performing sacrocolpopexy.

Impact of permanent versus absorbable suture in vaginal suspension surgery for apical pelvic organ prolapse

To systematically review the literature regarding how permanent versus absorbable suture impacts anatomic failure in women undergoing native-tissue vaginal apical suspension. MEDLINE and EMBASE were searched from their inception through 6/11/21 using pre-identified search terms. Our population included studies of women who underwent native-tissue vaginal apical suspensions (uterosacral ligament suspension (USLS) and sacrospinous ligament suspension (SSLF)). We excluded cadaver, tissue sample, or animal studies. We excluded hysteropexy and McCall culdoplasty. Our intervention was defined as permanent sutures (polytetrafluoroethylene, polypropylene, poliglecaprone 25, mersilene, silk, and nylon), excluding braided polyester suture. Our comparator group was absorbable or delayed absorbable sutures (polyglactin, polydioxanone, and polyglyconate). Outcomes included anatomic failure defined by POP-Q measurements, stage or grade, subjective symptoms of a bulge, re-operations, or re-treatments. A single composite anatomic failure proportion was determined for each study. Adverse events including suture exposure, surgery for suture complication, dyspareunia, and granulation tissue were collected. Abstracts were double-screened using Abstrackr, then full text articles were doubly screened, and then accepted articles were doubly extracted. Quality of studies was assessed using GRADE criteria. In studies using either absorbable or permanent sutures (single-arm studies), random effects meta-analyses of pooled proportions were used to assess anatomic failure. In studies investigating both suture types (comparative studies), random effect meta-analyses of pooled risk ratios were used. Analyses were performed using STATA, v.17 and p<=.05 was considered statistically significant. 4,357 abstracts were screened, 349 full-text papers assessed, and 20 studies met eligibility criteria (Figure 1). 4 studies (all USLS) compared both suture types, and 16 were single arm (8 USLS and 8 SSLF)(6 absorbable and 10 permanent). Mean follow up was 24.3 months. The proportional anatomic failure rate of absorbable suture (n=10) was 9% (95% CI 0.06, 0.13), and permanent suture (n=14) was 15% (95% CI 0.10, 0.20) with high heterogeneity. On meta-analysis, there was no difference in relative risk of failure for permanent sutures versus absorbable sutures (n=4), RR = 0.69 (95%CI 0.20, 2.36) with substantial heterogeneity (Figure 2). Overall, failure rate was low and similar for both absorbable and permanent suture for native tissue vaginal suspension with medium term follow-up.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

The Combined Use of Silicone and Green Braided Polyester ‎Suture (Ethibond) versus ‎Silicone or Ethibond Alone for Frontalis ‎Suspension Surgery in Children.

PurposeThis study aimed to report the outcomes of correcting severe congenital blepharoptosis by frontalis suspension using combined silicone tube and 2–0 green braided polyester suture (Ethibond), and to compare the results with those of silicone rod alone and Ethibond suture alone.Patients and MethodsThe medical records of patients below 16 years who underwent frontalis suspension were retrospectively reviewed. Three groups of patients were identified; group I (16 patients: 22 eyelids) had frontalis suspension surgery using silicone suspension set, group II (18 patients: 25 eyelids) underwent the surgery using Ethibond suture, and group III (15 patients: 23 eyelids) was operated on using combined silicone and Ethibond suture. The primary outcome measures were postoperative marginal reflex distance-1 (MRD-1) and postoperative symmetry, and the secondary outcome measures were the occurrence of complications; mainly recurrence and wound-related complications. The follow-up data were collected after 1 week, 1 month, 6 months, 12 months and every 6 months thereafter.ResultsThe follow-up period ranged from 18 to 36 months. By the last follow-up visit, 13 eyelids in silicone group (59%), 11 eyelids in the Ethibond group (44%), and 13 eyelids in the double sling group (57%) achieved good surgical correction with MRD1 ≥3mm; these differences were not statistically significant. The difference in symmetry among the three groups was not significant. The highest rates of recurrence (44%) and wound-related problems (8%) were encountered in the Ethibond group, while the silicone group had no cases of wound-related problems. The lowest recurrence rate (26.1%) was in the double sling group but those differences were not significant.ConclusionCombined use of silicone and Ethibond suture in frontalis suspension surgery could offer lower recurrence rate and good final surgical outcome when compared to silicone rod or Ethibond suture alone.

Management of Patella Fractures Non-amenable to Tension Band Wiring: Series of Nine Cases with Review of Literature.

Introduction:Patella fractures account for about 1% of all musculoskeletal injuries. Modified tension band wiring (TBW) is the most commonly used technique for the management of patella fractures. However, all patella fractures are not-amenable to TBW. In this series, we present nine cases managed with open reduction and internal fixation using non-absorbable braided polyester suture (Ethicon Ethibond Excel 5-0) with circumferential stainless-steel wiring.Case Series:This series included nine patients with fractured patella and managed with open reduction and internal fixation with non-absorbable sutures and circumferential wiring. Patient demographics, fracture type, time to union, functional outcome, and complications were recorded. Patients were followed up for minimum of 6 months (11.6 ± 3.7 months). All fractures went on to unite with average fracture healing time of 13.8 weeks. Mean Lyshom and Bostman score were 83 and 25.6, respectively. Seven patients had excellent to good outcome. One each had fair and poor outcomes. One patient developed superficial infection and knee stiffness.Conclusion:Open reduction and fixation with non-absorbable sutures augmented with circumferential wiring are an efficient method for the management of severely comminuted and multi-fragmentary lower pole patella fractures with minimum complications.

Augmented Medial Rectus Recession with Non-Absorbable Suture Loops is Effective in the Treatment of Convergence Excess Esotropia

ABSTRACT Aim:To evaluate the surgical outcomes of augmented medial rectus recession with non-absorbable 5.0 white braided polyester suture (Alcon Laboratories, Forth Worth, Texas, USA) loops in patients diagnosed with convergence excess esotropia. Methods: Clinical records of 21 patients with convergence excess esotropia who have been operated with symmetric medial rectus recessions augmented with non-absorbable suture loops were reviewed. Initial scleral bite was planned according to the distance deviation. Non-absorbable sutures tied leaving a loose loop which was 1 mm for a near–distance disparity of 10 PD, 1.5 mm for 15PD, and 2 mm for 20 PD. Postoperative changes in near-distance disparity were evaluated. Results: The mean preoperative near-distance disparity of 17,21 ± 1,68 standard mean of error (SE) prism diopters (PD) decreased to 3,15 ± 0,88 PD SE at 12 month postoperatively. Near-distance disparity of 10 PD or less was achieved in all patients after surgery at the sixth month, 1 patient showed 12 PD of disparity at the first-year control. No overcorrection has been noted. Conclusion: Bilateral medial rectus muscle recession procedure augmented with polyester suture loops effectively decreases the disparity between near and distance deviations in patients with convergence excess esotropia. Because of our good results and an easy, noninvasive approach without any additional complications, we recommend this technique to treat convergence excess esotropia

Comparison of double-strand braided polyester sutures tension band (Nice knot) with cable tension band in transverse patellar fractures

BackgroundThe tension band technique is the most common method for internal fixation of transverse patellar fractures. Titanium cable and high-strength sutures have been successfully applied in this treatment; however, few studies have compared the Nice knot technique using sutures with the standard cable technique. Whether the suture technique (Nice knot) provides preferable results compared with those of the cable technique is unclear. MethodsForty patients with transverse patellar fractures participated in this study. Twenty patients underwent sutures tension band fixation (Nice knot), and the others were managed with cable tension bands. All patients were followed up at 1, 3, 6, and 12 months. Pain was measured by VAS scores, flexion and extension of the knee were measured in degrees by goniometry, and knee function was evaluated using the Böstman clinical grading scale. ResultsThe two groups had equal distributions in age, gender, injured side, and fracture classification. The mean operation time in the suture group was shorter (55.75±9.77 minutes versus 64.25±9.63 minutes). The VAS score was comparable in the two groups at the 1-month, 3-month, and 6-month follow-ups; however, the score was lower at 12 months postoperatively in the suture group (P=0.037). No significant difference was found in flexion, extension, Böstman score, or fracture healing time in either group (P>0.05). Postoperative complications were higher in the cable group (9 versus 2) (P = 0.031) but were mostly related to symptomatic soft tissue irritation. ConclusionThe suture tension band technique using braided polyester nonabsorbable sutures tied with Nice knot was as effective as the cable tension band technique for transverse patellar fracture management. However, more convenient operations, less cost and fewer complications were found in suture fixation (Nice knot).

Hamstring Graft Prepared With Suture Tape Is Effective in Anterior Cruciate Ligament Reconstruction: A Biomechanical Analysis

PurposeTo investigate the graft diameters and mechanical properties of hamstring tendons sutured using different materials and techniques.MethodsThis study used 30 fresh, frozen human cadaveric semitendinosus tendons; the free ends of 10 specimens each were sutured by 2 No. 3 braided polyester sutures with the Krackow technique (BP group), SutureTape with the Krackow technique (ST group), or SutureTape Loop with the locking SpeedWhip technique (SL group). First, the changes in graft diameter from before suturing to after suturing were investigated. Each graft was pre-tensioned to 100 N for 3 cycles and then cyclically loaded to 200 N for 200 cycles. Elongation after cyclic loading and displacement in the 200th cycle were calculated. Finally, each specimen was loaded to failure. The ultimate failure load and stiffness were analyzed. These mechanical properties were statistically analyzed using 1-way analysis of variance. The level of statistical significance was set at P < .05.ResultsIn the BP group, the changes in graft diameter were significantly larger than those in the ST and SL groups (P = .001). The elongation values after 200 cycles in the BP and ST groups were 3.1 ± 2.0 mm and 5.9 ± 3.4 mm, respectively. In the SL group, elongation (7.7 ± 3.6 mm) was significantly larger compared with that in the BP group (P = .037). In contrast, displacement in the 200th cycle was significantly smaller in the ST and SL groups compared with the BP group (P = .017). No statistically significant difference was evident for the ultimate failure loads among the 3 groups (P = .543).ConclusionsThe results of this study suggest that SutureTape may be an appropriate option for preparing the hamstring graft in anatomic anterior cruciate ligament (ACL) reconstruction.Clinical RelevanceThis biomechanical study shows the effectiveness of SutureTape in ACL graft preparation. Clinically, SutureTape may be of benefit in single- or double-bundle ACL reconstruction.