title: Abrasiveness of high-strength sutures used in rotator cuff surgery: are they all the same?
abstract: BACKGROUND
  The suture-tendon interface remains the most common point of failure in rotator cuff repairs via suture pullout. Several high-strength braided sutures are available for rotator cuff surgery and are more abrasive than monofilaments. However, a comparison of these sutures has not been performed in a tissue model.
  
  
  METHODS
  Ninety infraspinatus sheep tendons were randomized among 9 groups of sutures (n = 10), including FiberWire (Arthrex, Naples, FL, USA), Collagen Coated FiberWire (Arthrex), Orthocord (DePuy Mitek, Raynham, MA, USA), MaxBraid (Biomet, Warsaw, IN, USA), Force Fiber (Teleflex, Research Triangle Park, NC, USA), ULTRABRAID (Smith & Nephew, Memphis, TN, USA), Phantom Fiber BioFiber (Tornier, Bloomington, MN, USA), and Ti-Cron (Syneture, Mansfield, MA), with Surgipro (Syneture) monofilament as a control. Each suture was cycled 50 times through the tendon, which was fixed to a mechanical testing system under a constant load in saline solution. The distance cut through the tendon was measured and divided by the distance of suture sliding to determine displacement (mm/cm). Twist angle and picks per inch of each suture were measured using digital photography. One-way analysis of variance was used to compare the displacement and twist angle between sutures.
  
  
  RESULTS
  Collagen Coated FiberWire was the most abrasive of the high-strength sutures. Four of the sutures (Collagen Coated FiberWire, Phantom Fiber BioFiber, FiberWire, Ti-Cron) had a mean displacement rate greater than 0.150 mm/cm. The remainder of the sutures had a mean displacement rate less than 0.050 mm/cm (Orthocord, Force Fiber, MaxBraid, ULTRABRAID). The difference in the displacement rates between these 2 groups was significant (P < .0001) and was related to both the twist angle and the picks per inch.
  
  
  CONCLUSIONS
  Significant differences in suture abrasiveness were identified among high-strength braided sutures and correlated with lower twist angle and lower picks per inch.
authors.affiliation: Division of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Johnathan F
authors.initials: JF
authors.lastname: Williams
authors.affiliation: Division of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Shaan S
authors.initials: SS
authors.lastname: Patel
authors.affiliation: Division of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Dustin K
authors.initials: DK
authors.lastname: Baker
authors.affiliation: Department of Biomedical Engineering, University of Alabama at Birmingham School of Engineering, Birmingham, AL, USA.
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Schwertz
authors.affiliation: Department of Epidemiology, University of Alabama at Birmingham School of Public Health, Birmingham, AL, USA.
authors.forename: Gerald
authors.initials: G
authors.lastname: McGwin
authors.affiliation: Division of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, AL, USA. Electronic address: bponce@uabmc.edu.
authors.forename: Brent A
authors.initials: BA
authors.lastname: Ponce
mesh_terms: D000818:Animals; D004867:Equipment Design; D017276:Friction; D019637:Orthopedic Procedures; D017006:Rotator Cuff / Q000601:surgery*; D012421:Rupture / Q000209:etiology; D012756:Sheep; D013499:Surface Properties; D013537:Sutures / Q000009:adverse effects*
keywords: Shoulder; abrasion; braided suture; repair strength; rotator cuff