Skip to main content
Top
Published in: European Journal of Orthopaedic Surgery & Traumatology 1/2013

01-01-2013 | Original Article

Whip stitch versus grasping suture for tendon autograft

Authors: Ruy E. da Assunção, Roger Haddad, Warwick J. M. Bruce, Peter Walker, William R. Walsh

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 1/2013

Login to get access

Abstract

Purpose

During tendon autograft harvest, either a grasping suture or traditional whip stitch can be used to grasp tendon prior to definitive bone fixation. Their grip strength has not, to our knowledge, been compared. This article compares a needle-free suture technique to a standard whip stitch by testing grip strength in vitro.

Methods

Twelve uniform ovine flexor tendons were prepared; six tendons with a standard, non-locking whip stitch and six tendons with a grasping suture. All the samples were tested to failure in uniaxial tension in a materials testing machine. Load/displacement curves were generated, and qualitatively assessed and peak loads were compared.

Results

There were no significant differences between the groups in tendon length or diameter. Modes of failure between the groups, as characterised by the load/displacement curves, were quite distinct. Peak load to failure was lower in the utility suture group (mean peak load at failure 121.28 N) than the whip stitch group (mean peak load to failure 188.82 N). All failures in the utility suture group occurred when the suture snapped.

Conclusions

The grasping suture described here is weaker than a standard whip stitch but may be sufficiently strong to harvest and handle tendon autograft. A standard whip stitch remains the choice for definitive graft fixation.
Literature
1.
go back to reference Lyman S, Koulouvaris P, Sherman S, Do H, Mandl LA, Marx RG (2009) Epidemiology of anterior cruciate ligament reconstruction. Trends, readmissions, and subsequent knee surgery. J Bone Jt Surg Am 91(10):2321–2328CrossRef Lyman S, Koulouvaris P, Sherman S, Do H, Mandl LA, Marx RG (2009) Epidemiology of anterior cruciate ligament reconstruction. Trends, readmissions, and subsequent knee surgery. J Bone Jt Surg Am 91(10):2321–2328CrossRef
2.
go back to reference Ibrahim SAR, Ahmad FHF, Salah M, Al Misfer ARK, Ghaffer SA, Khirat S (2008) Surgical management of traumatic knee dislocation. Arthroscopy 24(2):178–187 Ibrahim SAR, Ahmad FHF, Salah M, Al Misfer ARK, Ghaffer SA, Khirat S (2008) Surgical management of traumatic knee dislocation. Arthroscopy 24(2):178–187
3.
go back to reference Colvin AC, West RV (2008) Patellar instability. J Bone Jt Surg Am 90(12):2751–2762CrossRef Colvin AC, West RV (2008) Patellar instability. J Bone Jt Surg Am 90(12):2751–2762CrossRef
4.
go back to reference Martin DK FM (2007) Anterior cruciate ligament graft preparation: a new and quick alternative to the whipstitch. Arthroscopy 23(3):326.e321–326.e323 Martin DK FM (2007) Anterior cruciate ligament graft preparation: a new and quick alternative to the whipstitch. Arthroscopy 23(3):326.e321–326.e323
5.
go back to reference Hausmann J-T, Vekszler G, Bijak M, Benesch T, Vecsei V, Gabler C (2009) Biomechanical comparison of modified kessler and running suture repair in 3 different animal tendons and in human flexor tendons. J Hand Surg 34(1):93–101CrossRef Hausmann J-T, Vekszler G, Bijak M, Benesch T, Vecsei V, Gabler C (2009) Biomechanical comparison of modified kessler and running suture repair in 3 different animal tendons and in human flexor tendons. J Hand Surg 34(1):93–101CrossRef
Metadata
Title
Whip stitch versus grasping suture for tendon autograft
Authors
Ruy E. da Assunção
Roger Haddad
Warwick J. M. Bruce
Peter Walker
William R. Walsh
Publication date
01-01-2013
Publisher
Springer-Verlag
Published in
European Journal of Orthopaedic Surgery & Traumatology / Issue 1/2013
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI
https://doi.org/10.1007/s00590-011-0931-6

Other articles of this Issue 1/2013

European Journal of Orthopaedic Surgery & Traumatology 1/2013 Go to the issue