High-Tensile Strength Tape Versus High-Tensile Strength Suture: A Biomechanical Study.
OBJECTIVE
To determine which suture design, high-tensile strength tape or high-tensile strength suture, performed better at securing human tissue across 4 selected suture techniques commonly used in tendinous repair, by comparing the total load at failure measured during a fixed-rate longitudinal single load to failure using a biomechanical testing machine.


METHODS
Matched sets of tendon specimens with bony attachments were dissected from 15 human cadaveric lower extremities in a manner allowing for direct comparison testing. With the use of selected techniques (simple Mason-Allen in the patellar tendon specimens, whip stitch in the quadriceps tendon specimens, and Krackow stitch in the Achilles tendon specimens), 1 sample of each set was sutured with a 2-mm braided, nonabsorbable, high-tensile strength tape and the other with a No. 2 braided, nonabsorbable, high-tensile strength suture. A total of 120 specimens were tested. Each model was loaded to failure at a fixed longitudinal traction rate of 100 mm/min. The maximum load and failure method were recorded.


RESULTS
In the whip stitch and the Krackow-stitch models, the high-tensile strength tape had a significantly greater mean load at failure with a difference of 181 N (P = .001) and 94 N (P = .015) respectively. No significant difference was found in the Mason-Allen and simple stitch models. Pull-through remained the most common method of failure at an overall rate of 56.7% (suture = 55%; tape = 58.3%).


CONCLUSIONS
In biomechanical testing during a single load to failure, high-tensile strength tape performs more favorably than high-tensile strength suture, with a greater mean load to failure, in both the whip- and Krackow-stitch models. Although suture pull-through remains the most common method of failure, high-tensile strength tape requires a significantly greater load to pull-through in a whip-stitch and Krakow-stitch model.


CONCLUSIONS
The biomechanical data obtained in the current study indicates that high-tensile strength tape may provide better repair strength compared with high-tensile strength suture at time-zero simulated testing.
Orthopaedic Surgery Department, Dana C. Covey Orthopaedic Biomechanics Laboratory, Naval Medical Center San Diego, San Diego, California, U.S.A.
Ryan J
RJ
Gnandt
Orthopaedic Surgery Department, Dana C. Covey Orthopaedic Biomechanics Laboratory, Naval Medical Center San Diego, San Diego, California, U.S.A.
Jennifer L
JL
Smith
Orthopaedic Surgery Department, Dana C. Covey Orthopaedic Biomechanics Laboratory, Naval Medical Center San Diego, San Diego, California, U.S.A.
Kim
K
Nguyen-Ta
Orthopaedic Surgery Department, Dana C. Covey Orthopaedic Biomechanics Laboratory, Naval Medical Center San Diego, San Diego, California, U.S.A.
Lucas
L
McDonald
Orthopaedic Surgery Department, Dana C. Covey Orthopaedic Biomechanics Laboratory, Naval Medical Center San Diego, San Diego, California, U.S.A.. Electronic address: LeClere.Navy.Sports@gmail.com.
Lance E
LE
LeClere
D001696:Biomechanical Phenomena; D006801:Humans; D053832:Surgical Tape; D013536:Suture Techniques; D013537:Sutures; D013710:Tendons / Q000502:physiology / Q000601:surgery*; D013718:Tensile Strength; D014945:Wound Healing