In vitro biomechanical study testing stiffness, load at failure, and elongation of 18-gauge stainless steel wire, Mersilene tape, and single-through-four-loop configurations of No. 5 Ethibond suture — asking how many suture loops are needed to match wire, and whether knot configuration matters.
When stainless steel wire is unavailable or contraindicated, four loops of No. 5 Ethibond can match its failure strength — but the dramatically lower stiffness means it is appropriate for compliant repairs (patellar tendon augmentation, AC joint reconstruction) and not for rigid tension band fracture fixation.
Use individually tied offset knots rather than one large bundled knot to maximize stiffness and avoid a bulky subcutaneous prominence.
In vitro biomechanical study testing stiffness, load at failure, and elongation of 18-gauge stainless steel wire, Mersilene tape, and single-through-four-loop configurations of No. 5 Ethibond suture — asking how many suture loops are needed to match wire, and whether knot configuration matters.
When stainless steel wire is unavailable or contraindicated, four loops of No. 5 Ethibond can match its failure strength — but the dramatically lower stiffness means it is appropriate for compliant repairs (patellar tendon augmentation, AC joint reconstruction) and not for rigid tension band fracture fixation.
Use individually tied offset knots rather than one large bundled knot to maximize stiffness and avoid a bulky subcutaneous prominence.