Unlike other high-strength orthopaedic sutures which may experience laxity, DYNACORD Suture is specifically designed to shorten when compression is lost, thereby minimizing gap formation.1,2 Through axial contraction, DYNACORD Suture has been shown in pre-clinical testing to mitigate suture laxity, creep, knot slippage or the loss of compression due to load spikes.‡ 1,4,5
“The idea of a suture that minimizes tissue gapping and gently improves tendon-to-bone contact was born based on observations during daily practice such as loss of suture tension immediately after tying and/or after inadvertent overload episodes during early rehabilitation. I believe that DYNACORD Suture and its innovative technology could help address unmet needs in soft tissue repairs,” said design surgeon Prof. Dr. med. Ralph Hertel of the Shoulder and Elbow Center, Bern, Switzerland.†
Rotator cuff tears are a common cause of shoulder pain and dysfunction amongst athletes and the aging population. In fact, in 30 percent to 70 percent of shoulder pain cases, the pain is related to disorders of the rotator cuff, and the incidence of rotator cuff tears varies between 5 percent and 40 percent.6 In rotator cuff repairs, which are intended to reduce pain and restore function, shoulder surgeons reattach the tissue to the upper arm utilizing sutures and anchors. However, structural failure of the repair occurs in a substantial number of cases and can lead to an unsatisfactory result. One meta-analysis of more than 8,000 rotator cuff repairs showed a mean re-tear rate of 26.6 percent.7 Furthermore, the revision rate for large to massive rotator cuff tears has been reported to be as high as 90 percent.8
DYNACORD Suture was designed to address the key goals of an ideal rotator cuff repair, including higher initial fixation strength, contact area and contact pressure at the tendon-bone interface, minimal gap formation, and sustained mechanical stability.8 The suture consists of two outer sheaths of braided fibers and a core comprised of silicone and salt, and when it is used in a repair, the salt particles within the silicone core dissolve, leaving behind a porous structure. These small voids then fill with surrounding fluid as the core hydrates, causing the braided sheath to expand outward and the suture to shorten in length if there is a loss in tension, thereby reducing laxity and helping to maintain footprint compression.
“The self-tensioning aspect of DYNACORD Suture is a great advancement. Maintaining suture tension protects my repairs from laxity and helps the suture stay in place for longer periods of time,” said Emilio Calvo, M.D., head of the Department of Orthopedic Surgery and Traumatology and Professor of Orthopedics at Fundación Jiménez Díaz in Madrid, Spain.† 1,3
Compared to a leading Ultra-High Molecular Weight Polyethylene (UHMWPE) suture tested, DYNACORD Suture also delivers superior knot security and 28 percent lower abrasiveness for a more secure repair.‡ 4,9 Furthermore, in an in-vivo ovine tendon repair model, self-tensioning resulted in no strangulation nor necrosis of tissue.‡ 3
“The European launch of DYNACORD Suture demonstrates our ongoing commitment to introducing innovative solutions for sports medicine surgeons to help make continued advancements in the field of soft tissue repair,” said Wulf Radermacher, European lead for DePuy Synthes Mitek Sports Medicine, Synthes GmbH. “Our core objective is to continue to create innovative soft tissue repair solutions designed to equip orthopaedic surgeons with trusted and versatile choices to help them improve patient care.”
DYNACORD Suture is now available in select markets in Europe, the Middle East and Africa. The suture is offered in conjunction with HEALIX ADVANCE Anchors, as well as in free-strand form with and without needles.
*The Johnson & Johnson Medical Devices Companies comprise the surgery, orthopaedics, vision and interventional solutions businesses within the Johnson & Johnson's Medical Devices segment.
**DePuy Synthes represents the products and services of DePuy Synthes, Inc. and its affiliates.
†Paid consultant to DePuy Synthes, Inc.
‡Animal and bench testing results may not necessarily be indicative of clinical performance
1 DePuy Synthes. Approximation Force Design Verification Report. Ref# 103394861.
2 DePuy Synthes. Compression Study. Ref# 103653516.
3 Favorito P. J., et al. Safety evaluation of a laxity-minimizing suture at 5 days and 6 weeks after repair of a sheep infraspinatus tendon. J Shoulder Elbow Surg. 2019 Jan;28(1):164-169.
4 DePuy Synthes. Bench-top test results. Results of Knot Security Evidence Generation Study. Ref# 103412391.
5 DePuy Synthes. Results of Cycling Load Evidence Generation Study. Notebook 2017-06 page 86,89. Notebook 2017-11 page 19,51.
6 Oliva F, Piccirilli E, Bossa M, et al. I.S.Mu.L.T - Rotator Cuff Tears Guidelines. Muscles, Ligaments and Tendons Journal. 2015 Oct-Dec;5(4):227-263. DOI: 10.11138/mltj/2015.5.4.227.
7 McElvany, D., McGoldrick, E., Gee, A., Neradilek, M., and Matsen, F. Rotator Cuff Repair: Published Evidence on Factors Associated with Repair Integrity and Clinical American Journal of Sports Medicine. Published online 21 April 2014.
8 Yeh ML, et al. Current Biomechanical Concepts of Suture Bridge Repair Technique for Rotator Cuff Tear. International Journal of Orthopaedics 2015;23(3):284-288.
9 Owens, B., Algeri, J., Liang, V., and DeFroda, S. Bench-top test results. Rotator cuff tendon tissue cut-through comparison between 2 high–tensile strength sutures. Journal of Elbow and Shoulder Surgery. https://doi.org/10.1016/j.jse.2019.02.028.