The Biomechanical Properties of a High-Tensile Strength Tape for Tendon Graft Fixation Using the Krackow Configuration

Chih-Kai Hong; Kai-Lan Hsu; Fa-Chuan Kuan; Yueh Chen; Chen-Hao Chiang; Ming-Long Yeh; Miin-Jye Wen; Wei-Ren Su

doi:10.1016/j.asmr.2020.05.002

The Biomechanical Properties of a High-Tensile Strength Tape for Tendon Graft Fixation Using the Krackow Configuration

Arthrosc Sports Med Rehabil. 2020 Jul 9;2(4):e347-e351. doi: 10.1016/j.asmr.2020.05.002. eCollection 2020 Aug.

Authors

Chih-Kai Hong¹, Kai-Lan Hsu^{1

2}, Fa-Chuan Kuan^{1

2}, Yueh Chen³, Chen-Hao Chiang^{2

4}, Ming-Long Yeh^{2

5}, Miin-Jye Wen⁶, Wei-Ren Su^{1

7}

Affiliations

¹ Department of Orthopaedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
² Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan.
³ Department of Orthopaedic Surgery, Sin Lau Hospital, Tainan, Taiwan.
⁴ Department of Orthopedic Surgery, Chiayi Christian Hospital, Chiayi, Taiwan.
⁵ Medical Device Innovation Center, National Cheng Kung University, Tainan, Taiwan.
⁶ Department of Statistics, National Cheng Kung University, Tainan, Taiwan.
⁷ Skeleton Materials and Bio-compatibility Core Lab, Research Center of Clinical Medicine, College of Medicine, National Cheng Kung University.

Abstract

Purpose: To compare the biomechanical properties of a high-tensile strength suture with the high-tensile strength tape for tendon graft fixation.

Methods: A total of 24 porcine tendons were used and were randomly divided into 2 groups. Two kinds of suture materials, a braided nonabsorbable high-strength suture (group S) and a high-tensile strength tape (group T), were used to complete 3 pairs of Krackow stitches on the tendons. Each specimen was pretensioned to 100 N for 3 cycles, cyclically loaded from 50 to 200 N for 200 cycles, and finally loaded to failure. Elongation after cyclic loading, ultimate failure load, and the mode of failure were recorded.

Results: The elongation after cyclic loading between group S (26% ± 5%) and group T (24% ± 5%) were not significantly different (P = .378). The ultimate failure loads in group T (400 ± 38 N) were significantly greater than those in group S (358 ± 21 N) (P = .010). All specimens failed because of suture material breakage.

Conclusions: Compared with the braided nonabsorbable high-strength suture, the high-tensile strength tape had similar elongation values after cyclic loading, but significantly greater ultimate failure load in this porcine in vitro biomechanical model.

Clinical relevance: A secure suture-tendon construct is especially important when a post-tie fixation technique is used because the mitigating construct may potentially lead to graft loosening and affect graft healing.