ABSTRACT
Nickel-titanium shape memory alloy (NiTi) is a new suture material that is easy to handle, is strong, and biocompatible. The purpose of this study was to evaluate the material properties and biomechanical behaviour of 150 microm and 200 microm NiTi wires in flexor tendon repair. Braided polyester (4-0 Ethibond) was used as control. Fifty fresh-frozen porcine flexor tendons were repaired using the Pennington modification of the Kessler repair or a double Kessler technique. NiTi wires were stiffer and reached higher tensile strength compared to braided polyester suture. Repairs with 200 microm NiTi wire had a higher yield force, ultimate force and better resistance to gapping than 4-0 braided polyester repairs. Repairs made with 200 microm NiTi wire achieved higher stiffness and ultimate force than repairs made with 150 microm NiTi wire.
Subject(s)
Materials Testing , Sutures , Tendons/surgery , Tensile Strength , Animals , Biomechanical Phenomena , Nickel , Polyesters , Suture Techniques , Swine , TitaniumSubject(s)
Orthopedic Procedures/methods , Tendons/surgery , Biomechanical Phenomena , Humans , Immobilization , Suture Techniques , SuturesABSTRACT
The purpose of the present study was to investigate in vitro the biomechanical material and knot properties and histomorphometrical knot properties of 3-0 braided polyester suture (Ticron) and bioabsorbable poly-L/D-lactide (PLDLA) 96/4 suture. In Ticron five throws are needed to form a secure knot, and the 1 = 1 = 1 = 1 = 1 and the 2 = 1 = 1 = 1 configurations are recommended. For PLDLA several granny and square knots formed a secure knot, but the 1 = 1 and 1 = 1 = 1 knots were the best. These PLDLA knots had lower yield force and strain at yield point, but higher stiffness than the recommended Ticron knots. The ultimate force values did not differ, but PLDLA knots had significantly higher strain at ultimate point. In the histomorphometrical analysis of the recommended knots, the PLDLA knots had a significantly smaller knot surface area than the Ticron knots. According to these results, PLDLA suture proved to be suitable for flexor tendon repair.
Subject(s)
Absorbable Implants , Biocompatible Materials/chemistry , Lactic Acid/chemistry , Polyesters/chemistry , Polymers/chemistry , Suture Techniques , Sutures , Tendons/pathology , Biomechanical Phenomena , Biomedical Engineering , Humans , Materials Testing , Models, Statistical , Tensile StrengthABSTRACT
Five core suture techniques were compared by static tensile testing in vitro. Fifty porcine tendons were used. The core sutures were performed with 3-0 or 4-0 braided polyester suture (Ticron) and the over-and-over running peripheral sutures with 6-0 monofilament polypropylene (Prolene). The core sutures were: (1) Pennington modified Kessler (3-0), (2) Double Pennington modified Kessler (3-0), (3) 4-strand Savage (3-0), (4) 4-strand Savage (4-0), and (5) 6-strand Savage (4-0). Repairs were compared as paired in regard to one variable: the number of core suture strands, the suture calibre, or the suture configuration. Biomechanical differences between the repair groups started during the linear region, with the yield force and stiffness increasing along with the number of core suture strands. All three variables influenced the strain at the yield point. Thus, the strength of the intact repair can be improved by modifying the core suture. In all repairs gap formation started near the yield point after failure of the peripheral suture. The yield force represents the strength of the intact repair composite and should be considered the strength of the tendon repair.
