title: Comparison of the cheese-wiring effects among three sutures used in rotator cuff repair.
abstract: OBJECTIVE
  The goal of this study was to compare the cheese-wiring effects of three sutures with different coefficients of friction.
  
  
  METHODS
  Sixteen human cadaveric shoulders were dissected to expose the distal supraspinatus and infraspinatus muscle tendons. Three sutures were stitched through the tendons: #2 Orthocord(™) suture (reference #223114, DePuy Mitek, Inc., Raynham, MA), #2 ETHIBOND* EXCEL Suture, and #2 FiberWire(®) suture (FiberWire(®), Arthrex, Naples, FL). The sutures were pulled by cyclic axial forces from 10 to 70 N at 1 Hz for 1000 cycles through a MTS machine. The cut-through distance on the tendon was measured with a digital caliper.
  
  
  RESULTS
  The cut-through distance in the supraspinatus tendons (mean ± standard deviation, n = 12) were 2.9 ± 0.6 mm for #2 Orthocord(™) suture, 3.2 ± 1.2 mm for #2 ETHIBOND* suture, and 4.2 ± 1.7 mm for #2 FiberWire(®) suture. The differences were statistically significant analyzing with analysis of variance (P = 0.047) and two-tailed Student's t-test, which showed significance between Orthocord(™) and FiberWire(®) sutures (P = 0.026), but not significant between Orthocord(™) and ETHIBOND* sutures (P = 0.607) or between ETHIBOND* and FiberWire(®) sutures (P = 0.103).
  
  
  CONCLUSIONS
  The cheese-wiring effect is less in the Orthocord(™) suture than in the FiberWire(®) suture in human cadaveric supraspinatus tendons.
  
  
  CONCLUSIONS
  Identification of sutures that cause high levels of tendon cheese-wiring after rotator cuff repair can lead to better suture selection.
authors.affiliation: Department of Orthopaedic Surgery and Tulane Institute of Sports Medicine, Tulane University School of Medicine, New Orleans, LA 70112, USA ; Department of Structural and Cellular Biology, Tulane University School of Medicine, New Orleans, LA 70112, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Lambrechts
authors.affiliation: Department of Orthopaedics, Tabriz Emam Reza Hospital, Tabriz, Iran.
authors.forename: Behrooz
authors.initials: B
authors.lastname: Nazari
authors.affiliation: Department of Orthopaedic Surgery and Tulane Institute of Sports Medicine, Tulane University School of Medicine, New Orleans, LA 70112, USA.
authors.forename: Arash
authors.initials: A
authors.lastname: Dini
authors.affiliation: Department of Orthopaedic Surgery and Tulane Institute of Sports Medicine, Tulane University School of Medicine, New Orleans, LA 70112, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: O'Brien
authors.affiliation: Department of Orthopaedic Surgery and Tulane Institute of Sports Medicine, Tulane University School of Medicine, New Orleans, LA 70112, USA.
authors.forename: Wendell M R
authors.initials: WM
authors.lastname: Heard
authors.affiliation: Department of Orthopaedic Surgery and Tulane Institute of Sports Medicine, Tulane University School of Medicine, New Orleans, LA 70112, USA.
authors.forename: Felix H
authors.initials: FH
authors.lastname: Savoie
authors.affiliation: Department of Orthopaedic Surgery and Tulane Institute of Sports Medicine, Tulane University School of Medicine, New Orleans, LA 70112, USA ; Department of Structural and Cellular Biology, Tulane University School of Medicine, New Orleans, LA 70112, USA ; Tulane Cancer Center, Louisiana Cancer Research Consortium, Tulane Center for Aging, Tulane Center for Stem Cell Research and Regenerative Medicine, Tulane University School of Medicine, New Orleans, LA 70112, USA.
authors.forename: Zongbing
authors.initials: Z
authors.lastname: You
keywords: Biomechanics; cadaver study; cheese-wiring; supraspinatus tendon; suture