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Cyclic testing of meniscal sutures.
Arthroscopy. 2000 Jul-Aug; 16(5):505-10.A

Abstract

Suturing the meniscus has become a standard procedure for repairable tears. Studies investigating the outcome of meniscal sutures report a considerable rate of failures. Regarding the indications, which have been extended to the avascular zones, and regarding some accelerated rehabilitation protocols, the need for further in vitro investigations has become obvious. The aim of this study was to compare different meniscal suture types (vertical and horizontal mattress sutures) and materials (absorbable monofilament PDS 2-0, and nonabsorbable braided Ethibond 2-0 [Ethicon, Somerville, NJ]) under standard and cyclic loading conditions. Testing was performed on medial porcine menisci. In group A, specimens were tested to failure at a cross-head speed of 50 mm/minute. In group B, cyclic testing (100 cycles) was performed first within different load intervals (5 to 20 N and 5 to 40 N). Finally, the specimens were loaded until failure. In both groups, the failure loads were recorded and the failure modes were analyzed. In group A, there was no difference between suture type or suture material, with a mean failure load of 60 N. The failure modes were significantly different for vertical (100% suture failure) and horizontal sutures (50% suture failure) (P <.0001). In group B, 13% of the sutures failed under cyclic loading (7 with 40-N load, 1 with 20-N load). The gap of the sutured tear that appeared within the first load cycles was broader in horizontal sutures (P <.001). During the first cycles, the thread cut through the meniscus tissue and disappeared from the surface (partial tissue failure). There was no difference according to suture material. The ultimate failure loads after cyclic loading did not differ from the values of group A. These results show that meniscal sutures may fail under repetitive loading conditions and that a gap appears between the meniscal margins within the first loading cycles irrespective of the suture type and suture material used. The appearance of the gap and suture disappearance on the meniscal surface because of partial tissue failures (which were more pronounced in the horizontal sutures) confirmed the superior resistance of meniscal tissue to vertical sutures.

Authors+Show Affiliations

Department of Orthopaedic Surgery, the University of Saarland Medical School, Homburg/Saar, Germany.No affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

10882446

Citation

Seil, R, et al. "Cyclic Testing of Meniscal Sutures." Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association, vol. 16, no. 5, 2000, pp. 505-10.
Seil R, Rupp S, Kohn DM. Cyclic testing of meniscal sutures. Arthroscopy. 2000;16(5):505-10.
Seil, R., Rupp, S., & Kohn, D. M. (2000). Cyclic testing of meniscal sutures. Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association, 16(5), 505-10.
Seil R, Rupp S, Kohn DM. Cyclic Testing of Meniscal Sutures. Arthroscopy. 2000 Jul-Aug;16(5):505-10. PubMed PMID: 10882446.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cyclic testing of meniscal sutures. AU - Seil,R, AU - Rupp,S, AU - Kohn,D M, PY - 2000/7/6/pubmed PY - 2000/9/19/medline PY - 2000/7/6/entrez SP - 505 EP - 10 JF - Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association JO - Arthroscopy VL - 16 IS - 5 N2 - Suturing the meniscus has become a standard procedure for repairable tears. Studies investigating the outcome of meniscal sutures report a considerable rate of failures. Regarding the indications, which have been extended to the avascular zones, and regarding some accelerated rehabilitation protocols, the need for further in vitro investigations has become obvious. The aim of this study was to compare different meniscal suture types (vertical and horizontal mattress sutures) and materials (absorbable monofilament PDS 2-0, and nonabsorbable braided Ethibond 2-0 [Ethicon, Somerville, NJ]) under standard and cyclic loading conditions. Testing was performed on medial porcine menisci. In group A, specimens were tested to failure at a cross-head speed of 50 mm/minute. In group B, cyclic testing (100 cycles) was performed first within different load intervals (5 to 20 N and 5 to 40 N). Finally, the specimens were loaded until failure. In both groups, the failure loads were recorded and the failure modes were analyzed. In group A, there was no difference between suture type or suture material, with a mean failure load of 60 N. The failure modes were significantly different for vertical (100% suture failure) and horizontal sutures (50% suture failure) (P <.0001). In group B, 13% of the sutures failed under cyclic loading (7 with 40-N load, 1 with 20-N load). The gap of the sutured tear that appeared within the first load cycles was broader in horizontal sutures (P <.001). During the first cycles, the thread cut through the meniscus tissue and disappeared from the surface (partial tissue failure). There was no difference according to suture material. The ultimate failure loads after cyclic loading did not differ from the values of group A. These results show that meniscal sutures may fail under repetitive loading conditions and that a gap appears between the meniscal margins within the first loading cycles irrespective of the suture type and suture material used. The appearance of the gap and suture disappearance on the meniscal surface because of partial tissue failures (which were more pronounced in the horizontal sutures) confirmed the superior resistance of meniscal tissue to vertical sutures. SN - 0749-8063 UR - https://www.unboundmedicine.com/medline/citation/10882446/Cyclic_testing_of_meniscal_sutures_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0749-8063(00)94049-0 DB - PRIME DP - Unbound Medicine ER -