Loop security and tensile properties of polyblend and traditional suture materials

Tensile and knot properties of new generation (polyblend) and traditional suture materials in orthopedic surgery were investigated in standard laboratory conditions. Study focused on Fiberwire No. 5 and 2, Ethibond No. 5, 2 and 00, Orthocord No. 2, MaxBraid No. 2, Prolene No. 0 and 00, PDS No. 0 and 00, and Vicryl No. 2, 0 and 00. A 27-cm suture loop was fastened with 10 knots for ten samples for each type. Test parameters were tensile load to failure, elongation at failure point and knot slippage, and volume of 10-fold knots. Results were compared using ANOVA test. Failure load of No. 5 Fiberwire (625.0 ± 30.0 N) was significantly higher compared to all other suture types. Tensile strengths of MaxBraid No. 2 (287 ± 11 N) was significantly stronger compared to two other No. 2 polyblend sutures types and Ethibond No. 5. Knot slippage of Fiberwire No. 5 (14 ± 1.9 mm) was significantly higher compared to all other suture types. Ethibond No. 2 (0.1 ± 0.3 mm) had the lowest knot slippage. Elongation at the failure point of Fiberwire No. 2 (5%) was significantly lower than all other suture types. Mean calculated knot volume of #5 Fiberwire (73 ± 6.9 mm³) was significantly higher compared to #5 Ethibond (53 ± 4.8 mm³). Results of the study proved presence of significant differences between tensile and knot properties of various suture types and sizes. Loop security of larger diameter sutures is not always higher than thinner sutures. Suture elongation and knot slippage are important failure modes for high-diameter sutures and short-suture loops.