There is an increasing trend towards the use of anterior cruciate ligament (ACL) repair/reconstruction with internal bracing. Multiple studies have shown improved results in those who are indicated. Synthetic suture augmentation plays an important role in the treatment. However, to date, there have been no biomechanical studies comparing conventional suture tape and multiple high-strength sutures for the internal bracing of an ACL repair/reconstruction.
The purposes of this study are to compare the ultimate load-to-failure and the displacement after cyclic load that mimics the early phase of the postoperative ACL surgery rehabilitation program of ACL repair/reconstruction with synthetic augmentation between conventional suture tape and multiple high-strength sutures.
Study design: Controlled laboratory study.
Ten Thiel’s embalmed cadaveric knees were used and divided into 2 groups (5 knees in each group); (1) conventional suture tape, (2) multiple high-strength sutures. Each knee was augmented by the corresponding materials. Sine wave cyclic load 0-250 N with 1-Hz frequency for 1,000 cycles by Instron E10000 was applied to each knee. Finally, an axial distraction load to failure was applied at a knee in full extension in each group. The displacement and the ultimate load-to-failure were measured.
Multiple high-strength sutures group shows significantly better ultimate load-to-failure (1,690.7 N vs 987.6 N, P = .003) and less displacement after 1,000 cyclic loads (6.6 mm vs 16.3 mm, P < .001) compared to suture tape group.
Multiple high-strength sutures show better biomechanical properties for ACL internal bracing. The ultimate load-to-failure of suture tape and multiple high-strength sutures was higher than the natural ACL load. As a result, these materials could be used for augmentation to prevent the creeping of the ACL which is most vulnerable during the early phase of rehabilitation.