Implantable wireless suture sensor for in situ tendon and ligament strain monitoring

Tendon and ligament ruptures are prevalent, and severe sports injuries require surgical repair. In clinical practice, monitoring of tissue strain is critical to alert severe postoperative complications such as graft reinjury and loosening. Here, we present a sensor system that integrates a strain sensor and communication coil onto surgical silk sutures, enabling in situ monitoring and wireless readout of tissue strains via surgical implantation. The flexible sensor shows excellent adaptability to soft tissues, providing a strain monitoring range of 0 to 10% with a minimum detection threshold of 0.25% and maintaining stability more than 300,000 stretching cycles. The wireless sensor could be integrated with complex structures in surgical scenarios involving lateral collateral ligament injury and anterior cruciate ligament reconstruction, enabling distinct responses to graft stretching, reinjury, and loosening. Animal experiments demonstrate that the sensor can acquire real-time, clinical-grade strain data while exhibiting high biocompatibility. The sensor system shows considerable potential in evaluating preclinical implant performance and monitoring implant-related surgical complications.