{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:27:12Z","timestamp":1787754432081,"version":"build-2784847793"},"reference-count":35,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n \n \n \u00bb 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.<\/jats:p>\n <\/jats:list-item>\n \n \u00bb These sutures are critical for ensuring repair integrity during the healing process of tendon-to-bone or tendon-to-tendon constructs.<\/jats:p>\n <\/jats:list-item>\n \n \u00bb 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.<\/jats:p>\n <\/jats:list-item>\n \n \u00bb 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.<\/jats:p>\n <\/jats:list-item>\n \n \u00bb 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.<\/jats:p>\n <\/jats:list-item>\n \n \u00bb 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.<\/jats:p>\n <\/jats:list-item>\n \n \u00bb In addition, understanding key properties such as stiffness, creep, and knot security can help optimize outcomes and minimize complications.<\/jats:p>\n <\/jats:list-item>\n \n \u00bb 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.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>","DOI":"10.2106\/jbjs.rvw.24.00193","type":"journal-article","created":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T09:06:09Z","timestamp":1743152769000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":5,"title":["High-Tensile Strength Suture Materials in Orthopaedics"],"prefix":"10.2106","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9484-5693","authenticated-orcid":false,"given":"Naga Suresh","family":"Cheppalli","sequence":"first","affiliation":[{"name":"Department of Orthopedic and Rehabilitation, University of New Mexico, Albuquerque, New Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7044-9055","authenticated-orcid":false,"given":"Sreenivasulu","family":"Metikala","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Virginia Commonwealth University School of Medicine, Richmond, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7297-474X","authenticated-orcid":false,"given":"Prabhudev Prasad","family":"Purudappa","sequence":"additional","affiliation":[{"name":"VA Boston Health Care, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1281-8523","authenticated-orcid":false,"given":"Geneva","family":"Tranchida","sequence":"additional","affiliation":[{"name":"Department of Orthopedic and Rehabilitation, University of New Mexico, Albuquerque, New Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8766-826X","authenticated-orcid":false,"given":"Daniel C.","family":"Washer","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, University of New Mexico, Albuquerque, New Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,3]]},"reference":[{"key":"r1-20250325","first-page":"84","article-title":"Material properties of common suture materials in orthopaedic surgery","volume":"30","author":"Najibi","year":"2010","journal-title":"Iowa Orthop J"},{"issue":"4","key":"r2-20250325","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1111\/j.1469-7580.2006.00540.x","article-title":"Where tendons and ligaments meet bone: attachment sites (\u2018entheses\u2019) in relation to exercise and\/or mechanical load","volume":"208","author":"Benjamin","year":"2006","journal-title":"J Anat"},{"issue":"11","key":"r3-20250325","doi-asserted-by":"crossref","first-page":"2482","DOI":"10.2106\/00004623-200411000-00019","article-title":"Effect of gap size on gliding resistance after flexor tendon repair","volume":"86","author":"Zhao","year":"2004","journal-title":"J Bone Joint Surg Am"},{"issue":"2","key":"r4-20250325","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1016\/j.jse.2011.11.002","article-title":"The role of mechanobiology in tendon healing","volume":"21","author":"Killian","year":"2012","journal-title":"J Shoulder Elbow Surg"},{"issue":"2","key":"r5-20250325","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/j.jht.2011.07.004","article-title":"Tendon biomechanics and mechanobiology: a minireview of basic concepts and recent advancements","volume":"25","author":"Wang","year":"2012","journal-title":"J Hand Ther"},{"issue":"2","key":"r6-20250325","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1016\/j.arthro.2008.09.010","article-title":"Cyclic load and failure behavior of arthroscopic knots and high strength sutures","volume":"25","author":"Barber","year":"2009","journal-title":"Arthroscopy"},{"issue":"4","key":"r7-20250325","first-page":"167","article-title":"Ethibond: a new polybutylate coated polyester suture","volume":"6","author":"Capperauld","year":"1976","journal-title":"Polim Med"},{"issue":"5","key":"r8-20250325","doi-asserted-by":"crossref","first-page":"e1525","DOI":"10.1016\/j.asmr.2021.07.014","article-title":"Mechanical comparison of high-strength tape suture versus high-strength round suture","volume":"3","author":"Ensminger","year":"2021","journal-title":"Arthrosc Sports Med Rehabil"},{"issue":"10","key":"r9-20250325","doi-asserted-by":"crossref","first-page":"1897","DOI":"10.1016\/j.jse.2019.02.028","article-title":"Rotator cuff tendon tissue cut-through comparison between 2 high-tensile strength sutures","volume":"28","author":"Owens","year":"2019","journal-title":"J Shoulder Elbow Surg"},{"issue":"11","key":"r10-20250325","doi-asserted-by":"crossref","first-page":"1406","DOI":"10.1016\/j.arthro.2014.05.030","article-title":"Viscoelastic properties of common suture material used for rotator cuff repair and arthroscopic procedures","volume":"30","author":"Hurwit","year":"2014","journal-title":"Arthroscopy"},{"issue":"3","key":"r11-20250325","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1016\/j.arthro.2019.08.048","article-title":"A biomechanical comparison of different suture materials used for arthroscopic shoulder procedures","volume":"36","author":"Taha","year":"2020","journal-title":"Arthroscopy"},{"issue":"3","key":"r12-20250325","doi-asserted-by":"crossref","first-page":"e873","DOI":"10.1016\/j.asmr.2021.01.029","article-title":"High-strength suture Tapes are biomechanically stronger than high-strength sutures used in rotator cuff repair","volume":"3","author":"Borbas","year":"2021","journal-title":"Arthrosc Sports Med Rehabil"},{"issue":"5","key":"r13-20250325","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1016\/j.arthro.2004.03.005","article-title":"Arthroscopic knots: determining the optimal balance of loop security and knot security","volume":"20","author":"Lo","year":"2004","journal-title":"Arthroscopy"},{"issue":"2","key":"r14-20250325","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1016\/j.arthro.2004.09.024","article-title":"A biomechanical comparison of arthroscopic sliding and sliding-locking knots","volume":"21","author":"Elkousy","year":"2005","journal-title":"Arthroscopy"},{"issue":"12","key":"r15-20250325","first-page":"569","article-title":"Knot security, loop security, and elongation of braided polyblend sutures used for arthroscopic knots","volume":"39","author":"Livermore","year":"2010","journal-title":"Am J Orthop (Belle Mead NJ)"},{"issue":"6","key":"r16-20250325","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1016\/j.arthro.2009.10.011","article-title":"Biomechanical characteristics of 9 arthroscopic knots","volume":"26","author":"Dahl","year":"2010","journal-title":"Arthroscopy"},{"issue":"3","key":"r17-20250325","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1097\/JSA.0b013e3182199373","article-title":"Arthroscopic knots and strength sutures for rotator cuff repair","volume":"19","author":"Longo","year":"2011","journal-title":"Sports Med Arthrosc Rev"},{"issue":"11","key":"r18-20250325","doi-asserted-by":"crossref","first-page":"1146","DOI":"10.1016\/j.arthro.2006.06.013","article-title":"Mechanical and handling properties of braided polyblend polyethylene sutures in comparison to braided polyester and monofilament polydioxanone sutures","volume":"22","author":"W\u00fcst","year":"2006","journal-title":"Arthroscopy"},{"issue":"1","key":"r19-20250325","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1002\/jor.22185","article-title":"Bending and abrasion fatigue of common suture materials used in arthroscopic and open orthopedic surgery","volume":"31","author":"Savage","year":"2013","journal-title":"J Orthop Res"},{"issue":"1","key":"r20-20250325","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1016\/j.jse.2015.07.018","article-title":"Abrasiveness of high-strength sutures used in rotator cuff surgery: are they all the same?","volume":"25","author":"Williams","year":"2016","journal-title":"J Shoulder Elbow Surg"},{"issue":"8","key":"r21-20250325","doi-asserted-by":"crossref","first-page":"e191","DOI":"10.1016\/j.jse.2014.05.004","article-title":"Distal biceps brachii tendon repair complicated by a suture granuloma mimicking a soft-tissue sarcoma: a case report and review of the literature","volume":"23","author":"Sayari","year":"2014","journal-title":"J Shoulder Elbow Surg"},{"issue":"3","key":"r22-20250325","doi-asserted-by":"crossref","first-page":"680","DOI":"10.2106\/JBJS.H.00110","article-title":"Wound complications following the use of FiberWire in lower-extremity traumatic amputations. A case series","volume":"91","author":"Mack","year":"2009","journal-title":"J Bone Joint Surg Am"},{"key":"r23-20250325","doi-asserted-by":"crossref","first-page":"bcr2017222854","DOI":"10.1136\/bcr-2017-222854","article-title":"Granuloma formation associated with patellar tendon necrosis in response to Ethibond confirmed by histopathological examination","volume":"2018","author":"Blasco","year":"2018","journal-title":"BMJ Case Rep"},{"issue":"10","key":"r24-20250325","doi-asserted-by":"crossref","first-page":"720","DOI":"10.1016\/j.ijscr.2014.07.026","article-title":"Granuloma formation secondary to Achilles tendon repair with nonabsorbable suture","volume":"5","author":"Kara","year":"2014","journal-title":"Int J Surg Case Rep"},{"issue":"19","key":"r25-20250325","doi-asserted-by":"crossref","first-page":"12897","DOI":"10.3390\/ijerph191912897","article-title":"Clinical features and treatment of intra-tendinous suture reaction following Achilles tendon repair using nonabsorbable suture material: a retrospective case series study","volume":"19","author":"Kim","year":"2022","journal-title":"Int J Environ Res Public Health"},{"issue":"2","key":"r26-20250325","doi-asserted-by":"crossref","first-page":"e27","DOI":"10.1016\/j.fas.2014.01.006","article-title":"Foreign body granulomatous reaction associated with polyethelene \u2018Fiberwire\u2019 suture material used in Achilles tendon repair","volume":"20","author":"Ollivere","year":"2014","journal-title":"Foot Ankle Surg"},{"issue":"1","key":"r27-20250325","doi-asserted-by":"crossref","first-page":"2222807","DOI":"10.1080\/23320885.2023.2222807","article-title":"Inflammatory reaction to suture materials after flexor tendon repair. A retrospective study of 594 patients","volume":"10","author":"Arner","year":"2023","journal-title":"Case Reports Plast Surg Hand Surg"},{"issue":"1","key":"r28-20250325","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1186\/s13018-018-1026-4","article-title":"Suture wear particles cause a significant inflammatory response in a murine synovial airpouch model","volume":"13","author":"Lovric","year":"2018","journal-title":"J Orthop Surg Res"},{"issue":"11","key":"r29-20250325","doi-asserted-by":"crossref","first-page":"828","DOI":"10.3928\/01477447-20090922-11","article-title":"Biologic response to orthopedic sutures: a histologic study in a rabbit model","volume":"32","author":"Carr","year":"2009","journal-title":"Orthopedics"},{"issue":"2","key":"r30-20250325","doi-asserted-by":"crossref","first-page":"102","DOI":"10.5435\/00124635-201202000-00006","article-title":"Postarthroscopic glenohumeral chondrolysis","volume":"20","author":"Yeh","year":"2012","journal-title":"J Am Acad Orthop Surg"},{"issue":"11","key":"r31-20250325","doi-asserted-by":"crossref","first-page":"1329","DOI":"10.1016\/j.arthro.2009.06.001","article-title":"Glenohumeral chondrolysis after arthroscopy: a systematic review of potential contributors and causal pathways","volume":"25","author":"Solomon","year":"2009","journal-title":"Arthroscopy"},{"issue":"3","key":"r32-20250325","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1097\/JSA.0b013e3181eb6ca3","article-title":"Postarthroscopic glenohumeral chondrolysis of the shoulder","volume":"18","author":"Ryu","year":"2010","journal-title":"Sports Med Arthrosc Rev"},{"issue":"1","key":"r33-20250325","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1177\/0363546503260728","article-title":"Late foreign-body reaction to Ticron sutures following inferior capsular shift: a case report","volume":"32","author":"Warme","year":"2004","journal-title":"Am J Sports Med"},{"issue":"6","key":"r34-20250325","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1016\/j.arthro.2011.02.003","article-title":"Bacterial adherence to high: tensile strength sutures","volume":"27","author":"Masini","year":"2011","journal-title":"Arthroscopy"},{"issue":"12","key":"r35-20250325","doi-asserted-by":"crossref","first-page":"2325967120964480","DOI":"10.1177\/2325967120964480","article-title":"FiberWire vs FiberTape: comparison of bacterial adherence in a murine air pouch wound model","volume":"8","author":"Blumenthal","year":"2020","journal-title":"Orthop J Sports Med"}],"container-title":["JBJS Reviews"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.RVW.24.00193","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:27:26Z","timestamp":1787750846000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.RVW.24.00193"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3]]},"references-count":35,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.rvw.24.00193","relation":{},"ISSN":["2329-9185"],"issn-type":[{"value":"2329-9185","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3]]}}}