High-Tensile Strength Suture Materials in Orthopaedics.

Abstract

» High-tensile strength suture materials (HTSSMs) have significantly advanced the field of orthopaedic surgery by providing superior strength, enhanced handling characteristics, and improved durability compared with first-generation sutures.» These sutures are critical for ensuring repair integrity during the healing process of tendon-to-bone or tendon-to-tendon constructs.» While second-generation HTSSMs such as FiberWire, Orthocord, and Force Fiber offer higher tensile strength, better knot security, and reduced creep, their mechanical and biological properties vary, making it essential for surgeons to tailor their choice based on the tissue type, surgical technique, and patient-specific factors.» The incorporation of advanced materials such as ultra-high molecular weight polyethylene and innovative designs such as core-plus-braid configurations has further minimized risks of failure from abrasion, knot slippage, or tissue cut through.» Despite these advancements, challenges such as potential tissue irritation, granuloma formation, and suture cutout remain. Selecting the appropriate HTSSM involves balancing mechanical strength with handling properties and biological responses.» Flat sutures distribute load more evenly and are less prone to tissue cutout, making them ideal for delicate tissues, while round sutures offer better abrasion resistance in high-stress repairs.» In addition, understanding key properties such as stiffness, creep, and knot security can help optimize outcomes and minimize complications.» Surgeons should remain vigilant about the trade-offs associated with material coatings and knot volume, as these factors can influence both repair success and postoperative tissue health.