A biomechanical comparison of different tying techniques of a double-stranded looped suture

Purpose: This study aims to assess the biomechanical performance of different tying techniques of a double-stranded looped suture (DSLS). Methods: Loop and knot security of DSLS tying techniques (nice knot (NK), modified nice knot (MNK), double-twist knot (DTK), and double-barrel knot (DBK)) were co...

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Main Authors: Suriya Luenam, Poonsak Koonalinthip, Arkaphat Kosiyatrakul
Format: Article
Language:English
Published: SAGE Publishing 2019-12-01
Series:Journal of Orthopaedic Surgery
Online Access:https://doi.org/10.1177/2309499019888307
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author Suriya Luenam
Poonsak Koonalinthip
Arkaphat Kosiyatrakul
author_facet Suriya Luenam
Poonsak Koonalinthip
Arkaphat Kosiyatrakul
author_sort Suriya Luenam
collection DOAJ
description Purpose: This study aims to assess the biomechanical performance of different tying techniques of a double-stranded looped suture (DSLS). Methods: Loop and knot security of DSLS tying techniques (nice knot (NK), modified nice knot (MNK), double-twist knot (DTK), and double-barrel knot (DBK)) were compared. The square knot of DSLS (SKD) and the square knot of single-stranded suture (SKS) had been used as references. Twenty-four loops of each configuration were created using No. 2 Fiberwire (Arthrex, Naples, Florida, USA) and tested with a material testing machine. Samples were loaded with 10 N preloads for loop security assessment. Knot security was subsequently evaluated. Twelve loops of each knot were loaded to failure. The rest were subjected to cyclic load testing and the elongation at the 50th and 1000th cycles were measured. Knot bulkiness was determined by measuring knot height before testing. Data were compared with analysis of variance and post hoc tests. Statistical significance was p < 0.05. Results: All knots showed no statistically significant difference in displacement with preload. The load-to-failure was highest in NK, followed by MNK, DTK, DBK, SKD, and SKS. The cyclic loading test at the 50th cycle and the 1000th cycle demonstrated that NK has significantly less displacement than the others except MNK. DTK provided a minimal average knot height followed by NK, SKS, DBK, MNK, and SKD. Conclusion: The different tying techniques in DSLS provided the similar loop security but different knot security and knot bulkiness. NK and MNK are biomechanically superior to the other knots, whereas DTK is the least bulky. The findings in the present study may help set the guide for the surgeons to select the tying technique of DSLS to best suit their requirement.
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spelling doaj.art-e31d34f4649e4c3a96f5c2a45b0aed3e2022-12-22T00:05:31ZengSAGE PublishingJournal of Orthopaedic Surgery2309-49902019-12-012710.1177/2309499019888307A biomechanical comparison of different tying techniques of a double-stranded looped sutureSuriya LuenamPoonsak KoonalinthipArkaphat KosiyatrakulPurpose: This study aims to assess the biomechanical performance of different tying techniques of a double-stranded looped suture (DSLS). Methods: Loop and knot security of DSLS tying techniques (nice knot (NK), modified nice knot (MNK), double-twist knot (DTK), and double-barrel knot (DBK)) were compared. The square knot of DSLS (SKD) and the square knot of single-stranded suture (SKS) had been used as references. Twenty-four loops of each configuration were created using No. 2 Fiberwire (Arthrex, Naples, Florida, USA) and tested with a material testing machine. Samples were loaded with 10 N preloads for loop security assessment. Knot security was subsequently evaluated. Twelve loops of each knot were loaded to failure. The rest were subjected to cyclic load testing and the elongation at the 50th and 1000th cycles were measured. Knot bulkiness was determined by measuring knot height before testing. Data were compared with analysis of variance and post hoc tests. Statistical significance was p < 0.05. Results: All knots showed no statistically significant difference in displacement with preload. The load-to-failure was highest in NK, followed by MNK, DTK, DBK, SKD, and SKS. The cyclic loading test at the 50th cycle and the 1000th cycle demonstrated that NK has significantly less displacement than the others except MNK. DTK provided a minimal average knot height followed by NK, SKS, DBK, MNK, and SKD. Conclusion: The different tying techniques in DSLS provided the similar loop security but different knot security and knot bulkiness. NK and MNK are biomechanically superior to the other knots, whereas DTK is the least bulky. The findings in the present study may help set the guide for the surgeons to select the tying technique of DSLS to best suit their requirement.https://doi.org/10.1177/2309499019888307
spellingShingle Suriya Luenam
Poonsak Koonalinthip
Arkaphat Kosiyatrakul
A biomechanical comparison of different tying techniques of a double-stranded looped suture
Journal of Orthopaedic Surgery
title A biomechanical comparison of different tying techniques of a double-stranded looped suture
title_full A biomechanical comparison of different tying techniques of a double-stranded looped suture
title_fullStr A biomechanical comparison of different tying techniques of a double-stranded looped suture
title_full_unstemmed A biomechanical comparison of different tying techniques of a double-stranded looped suture
title_short A biomechanical comparison of different tying techniques of a double-stranded looped suture
title_sort biomechanical comparison of different tying techniques of a double stranded looped suture
url https://doi.org/10.1177/2309499019888307
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