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Abstract
We evaluated the conditions required for sutures tied to a post for tibial fixation during anterior cruciate ligament (ACL) reconstruction. Harvested porcine tendon was used as a graft material and nonabsorbable suture was used for sutures. Samples were tested for ultimate tensile load and elongation according to thread numbers, knot numbers, suture techniques and stitch numbers. As thread numbers were increased, ultimate tensile load was increased and elongation was decreased. However, more than 4 strands of threads provided the sufficient ultimate tensile load more than 454 N of normal ACL for daily activities. As knot numbers were increased, ultimate tensile load was increased, but elongation was decreased. In terms of failure mode, unraveling occurred 100% in 3 and 4 knots, 81.2% in 5 knots, 54.5% in 6 knots, and 0% in 7 knots. Suture techniques and stitch numbers didn't significantly affect the ultimate tensile load and the elongation. For sutures tied to a post for tibial fixation in ACL reconstruction, more than 4 threads, more than 7 knots, and more than 4 stitches provide adequate ultimate tensile load and elongation.
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Fig. 3.
Ultimate tensile load according to thread numbers, knot numbers, suture technique, and stitch numbers. ∗Significant difference compared to second column of the †Significant difference compared to respective group; second column of the respective group; ‡ Significant difference compared to third column of the respective group.
Fig. 4.
Enlongation according to thread numbers, knot numbers, suture technique, and stitch numbers. ∗Significant difference compared to first column of the respective group; †Significant difference compared to second column of the respective group; ‡ Significant difference compared to third column of the respective group; § Significant difference compared to fourth column of the respective group.
Table 1.
Failure mode according to knot numbers
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