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Mark Lambrechts1, Behrooz Nazari2, Arash Dini3, Michael J O'Brien3, Wendell M. R. Heard3, Felix H Savoie3, Zongbing You4
1 Department of Orthopaedic Surgery and Tulane Institute of Sports Medicine; Department of Structural and Cellular Biology, Tulane University School of Medicine, New Orleans, LA 70112, USA 2 Department of Orthopaedics, Tabriz Emam Reza Hospital, Tabriz, Iran 3 Department of Orthopaedic Surgery and Tulane Institute of Sports Medicine, Tulane University, School of Medicine, New Orleans, LA 70112, USA 4 Department of Orthopaedic Surgery and Tulane Institute of Sports Medicine; Department of Structural and Cellular Biology; Tulane Cancer Center, Louisiana Cancer Research Consortium, Tulane Center for Aging, Tulane Center for Stem Cell Research and Regenerative Medicine, Tulane University School of Medicine, New Orleans, LA 70112, USA
Correspondence Address:
Zongbing You 1430 Tulane Ave SL 49, New Orleans, LA 70112 USA
![Login to access the Email id](http://www.medknow.com/images/email.gif) Source of Support: This work was partially supported by a grant provided by DePuy Mitek, Inc., to Tulane University (No. 551206, to Z.Y., F.H.S., and M.J.O.). F.H.S. is an unpaid consultant of DePuy Mitek, Inc., Smith & Nephew plc, and Rotation Medical and Biomet Sports Medicine, as well as a board member of the rthroscopy Association of North America Education Foundation and of the Trustees for Arthroscopy., Conflict of Interest: None
DOI: 10.4103/0973-6042.140115
Purpose: The goal of this study was to compare the cheese-wiring effects of three sutures with different coefficients of friction.
Materials and methods: Sixteen human cadaveric shoulders were dissected to expose the distal supraspinatus and infraspinatus muscle tendons. Three sutures were stitched through the tendons: #2 Orthocord™ suture (reference #223114, DePuy Mitek, Inc., Raynham, MA), #2 ETHIBOND* EXCEL Suture, and #2 FiberWire® suture (FiberWire® , Arthrex, Naples, FL). The sutures were pulled by cyclic axial forces from 10 to 70 N at 1 Hz for 1000 cycles through a MTS machine. The cut-through distance on the tendon was measured with a digital caliper.
Results: The cut-through distance in the supraspinatus tendons (mean ± standard deviation, n = 12) were 2.9 ± 0.6 mm for #2 Orthocord™ suture, 3.2 ± 1.2 mm for #2 ETHIBOND* suture, and 4.2 ± 1.7 mm for #2 FiberWire® suture. The differences were statistically significant analyzing with analysis of variance (P = 0.047) and two-tailed Student's t-test, which showed significance between Orthocord™ and FiberWire® sutures (P = 0.026), but not significant between Orthocord™ and ETHIBOND* sutures (P = 0.607) or between ETHIBOND* and FiberWire® sutures (P = 0.103).
Conclusion: The cheese-wiring effect is less in the Orthocord™ suture than in the FiberWire® suture in human cadaveric supraspinatus tendons.
Clinical Relevance: Identification of sutures that cause high levels of tendon cheese-wiring after rotator cuff repair can lead to better suture selection.
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