Korean J Sports Med.  2014 Jun;32(1):14-19. 10.5763/kjsm.2014.32.1.14.

Optimal Parameters for Sutures Tied to a Post during Anterior Cruciate Ligament Reconstruction: Thread Numbers, Knot Numbers, Suture Techniques and Stitch Numbers: An Experimental Laboratory Study Using Porcine Tendon

  • 1Department of Orthopaedics, Gil Hospital, Gachon University, Incheon, Korea. bklee@gilhospital.com
  • 2Gachon Medical School, Gachon University, Incheon, Korea.
  • 3Solco Biomedical Institute, Solco Biomedical, Pyeongtaek, Korea.


We evaluated the conditions required for sutures tied to a post for tibial fixation during anterior cruciate ligament (ACL) reconstruction. Harvested porcine tendon was used as a graft material and nonabsorbable suture was used for sutures. Samples were tested for ultimate tensile load and elongation according to thread numbers, knot numbers, suture techniques and stitch numbers. As thread numbers were increased, ultimate tensile load was increased and elongation was decreased. However, more than 4 strands of threads provided the sufficient ultimate tensile load more than 454 N of normal ACL for daily activities. As knot numbers were increased, ultimate tensile load was increased, but elongation was decreased. In terms of failure mode, unraveling occurred 100% in 3 and 4 knots, 81.2% in 5 knots, 54.5% in 6 knots, and 0% in 7 knots. Suture techniques and stitch numbers didn't significantly affect the ultimate tensile load and the elongation. For sutures tied to a post for tibial fixation in ACL reconstruction, more than 4 threads, more than 7 knots, and more than 4 stitches provide adequate ultimate tensile load and elongation.


Knee; Anterior cruciate ligament reconstruction; Tibial fixation
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