Summary
Objective: To compare the ultimate tensile strength (UTS) and load to 1 and 3 mm gap formation
of smooth (3-metric) and knotless barbed (4-metric) polypropylene sutures placed in
a three-loop pulley pattern for canine gastrocnemius tendon repair.
Study design: In vitro.
Sample size: Thirty-three paired bonetendon units with one of each pair assigned to each suture
type. Barbed suture size was based on previously published materials testing results.
Methods: Each unit was placed in a servohydraulic testing machine and tested under single
cycle tensile loading until repair failure.
Results: There was a significantly higher UTS for smooth polypropylene compared to the barbed
polypropylene repairs. The loads resulting in 1 and 3 mm gaps for the barbed repairs
were consistently significantly less than the corresponding smooth polypropylene repair
values.
Conclusion: The knotted smooth polypropylene repair was consistently stronger than the knotless
barbed polypropylene repair when placed in a three-loop pulley pattern for gastrocnemius
repair.
Clinical significance: Knotless barbed polypropylene suture should not be considered equivalent to knotted
smooth polypropylene of comparable tensile strength when placed in a three-loop pulley
pattern for canine gastrocnemius tendon repair. The low failure loads of the barbed
repair are probably due to failure of the barbs to anchor consistently throughout
the tendon in the knotless configuration.
Keywords
Barbed suture - tensile testing - polypropylene - ultimate tensile strength