Gliding resistance and strength of composite sutures in human flexor digitorum profundus tendon repair: an in vitro biomechanical study.
OBJECTIVE
Although the strength of a tendon repair is clearly important, the friction of the repair is also a relevant consideration. The purpose of this study was to characterize the frictional coefficient, gliding resistance, and breaking strength of suture materials and a suture construct commonly used for flexor tendon repair.


METHODS
We measured the friction coefficients of 3-0 braided nylon enclosed in a smooth nylon outer shell (Supramid, S. Jackson, Alexandria, VA), 3-0 braided polyester coated with polybutilate (Ethibond, Ethicon, Somerville, NJ), and 3-0 braided polyester/monofilament polyethylene composite (FiberWire, Arthrex, Naples, FL) sutures. We also measured the gliding resistance, linear breaking strength, and resistance to gapping of zone 2 modified Pennington tendon repairs with the 2 lowest-friction sutures in 20 human cadaveric flexor digitorum profundus tendons.


RESULTS
The braided polyester/monofilament polyethylene composite had a significantly lower friction coefficient (0.054) than either the coated polyester (0.076) or nylon (0.130) sutures. The gliding resistances of the repaired tendons with braided/monofilament polyethylene composite suture and those of coated, braided polyester were similar. The strength of the 2 repairs (force to produce a 2 mm gap) and resistance to gap formation were also not significantly different.


CONCLUSIONS
Braided polyester composite is a low-friction suture material. However, when this suture was used for tendon repair with a locking suture technique, it did not show a significant effect on the gliding resistance and repair strength compared with the same repair using a coated polyester suture.
Silva
Jose M
JM
Biomechanics Laboratory, Division of Orthopedic Research, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
Zhao
Chunfeng
C
An
Kai-Nan
KN
Zobitz
Mark E
ME
Amadio
Peter C
PC
D000368:Aged; D000369:Aged, 80 and over; D001696:Biomechanical Phenomena; D002102:Cadaver; D005260:Female; D017276:Friction; D006801:Humans; D066298:In Vitro Techniques; D008297:Male; D008422:Materials Testing; D009757:Nylons; D011093:Polyethylene Terephthalates; D011095:Polyethylenes; D013536:Suture Techniques; D013537:Sutures; D013708:Tendon Injuries / Q000601:surgery*; D013710:Tendons / Q000502:physiology / Q000601:surgery; D013718:Tensile Strength
C014534:Ethibond; D009757:Nylons; D011093:Polyethylene Terephthalates; D011095:Polyethylenes