Medical constructs with twisted cables formed from a plurality of collagen fibers twisted together to form strands and those strands twisted together to form cables and relate methods of twisting the collagen fibers to form the medical constructs while holding the fibers and strands of fibers in tension and twisting in a first direction (i.e., in a clockwise direction), then twisting them in a second opposing (counterclockwise) direction for a number of twists per inch.
