Editorial Commentary: Stronger and Faster Suture Configuration-But Is It Better? Challenges of Surgical Innovation in the Modern Era.

Abstract

When evaluating the characteristics of a new surgical technique, it is important to consider practical effects of the technique on clinical practice, as it would be inappropriate to advocate for cost-prohibitive or excessively time-consuming methods, even if biomechanically superior. The Krackow stitch has long been considered the gold standard for suture-graft fixation; potential limitations with this technique include the risk of needle sticks to the surgical team and the time required to perform the stitch. A new proprietary method (SpeedTrap, DePuy-Mitek, Raynham, MA) offers a significantly faster solution with equivalent or better biomechanics; however, elongation of the suture-graft construct is still a concern, and the cost effectiveness remains unclear. Regardless, we are fortunate to be practicing in an era when we can have great appreciation for the problem-solving innovations of surgeons who practiced in prior decades as well as witness the continued effort to optimize clinical outcomes now and in the future.