Failure strengths of suture versus biodegradable arrow for meniscal repair: an in vitro study

Dervin, Geoffrey F.; Downing, Kristian J. W.; Keene, G; McBride, Daniel G.

doi:10.1016/s0749-8063(97)90024-4

Cited by 132 publications

(74 citation statements)

References 16 publications

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“…These have decreased the operating time and the level of surgical skill required 23 . These devices, which may be shaped like arrows, @ C I C E d i z i o n i I n t e r n a z i o n a l i screws or stitches 43,44 , reduce the surgical time, simplify the technique and reduce the risk of neurovascular lesions, although it has also been shown that there may be a reaction to the introduction of a foreign body, and they may damage the cartilage, become displaced in the joint 45,46 . This has led to the creation of a second generation of devices, which are more flexible, aimed at achieving a balance between the suture and rigid anchoring systems.…”

Section: Meniscal Suture Techniques and Their Biomechanical Consideramentioning

confidence: 99%

Meniscus tear surgery and meniscus replacement

Vaquero

Forriol

2016

MLTJ

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SummaryObjective: the menisci are easily injured and difficult to repair. The aim of this study was to analyze the current state of meniscal surgery aimed at preserving morphology and conserving the biomechanics of the knee to prevent joint degeneration. Methodology: a search of the electronic medical literature database Medline was conducted, from http://www.ncbi.nlm.nih.gov/pubmed. The search was not limited by language. Candidate articles were identified by searching for those that included the keywords meniscus, surgery, suture, implant, allograft. The limits were included for clinical research and clinical trials. Basic research was not included. The studies selected were evaluated and classified in three different categories: basic science, reconstruction (suture and meniscectomy) and implants (scaffolds and allograft). Results: the consequences of meniscectomy performed at a young age can lead to a joint cartilage degeneration twenty years later. There are few surgical options for the repair of meniscal injuries in order both to preserve the meniscus and to ensure the long term survival of the knee joint, meniscectomy, repair, suturing the tear, or reconstruction, when a meniscal allograft or synthetic substitute is used to replace the meniscus, but the biomechanical properties of the native meniscus are not reproduced entirely by the scaffolds that exist today.Conclusion: therapies that successfully repair or replace the meniscus are therefore likely to prevent or delay osteoarthritis progression.

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Section: Meniscal Suture Techniques and Their Biomechanical Consideramentioning

confidence: 99%

Meniscus tear surgery and meniscus replacement

Vaquero

Forriol

2016

MLTJ

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“…Ihr Versuchsaufbau, welcher später von Rimmer et al [24] modifiziert wurde, hat sich in der Literatur durchgesetzt [1,2,7,10,21,27]. Der Vorteil dieses Testverfahrens besteht darin, dass eine alleinige Meniskusnaht untersucht wird und die Methode demnach mit Erkenntnissen aus anderen Arbeiten vergleichbarer wird.Von Nachteil ist, dass die tatsächli-che In-vivo-Situation nur ansatzweise reproduziert wird.…”

Section: Diskussionunclassified

“…neue Rekonstruktionstechniken (Meniskuspfeil, Meniskusklammer, T-Fix) untersuchten [1,2,7,10,21,24,27], sind noch viele Fragen offen. So ist noch nicht geklärt, welchen Einfluss eine wiederholte, zyklische Belastung auf die Naht hat.…”

Section: Diskussionunclassified

Der Einfluss verschiedener Nahtstärken auf das Verhalten von Meniskusnähten unter zyklischer Zugbelastung

Seil

Rupp²,

Jurecka³

et al. 2001

Der Unfallchirurg

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The aim of this study was to analyze meniscal sutures under cyclic loading conditions for different suture types (vertical and horizontal mattress sutures) and suture materials (absorbable monofilament sutures: PDS 2-0; PDS-0, and PDS-1 USP). Testing was performed on medial porcine menisci, using a well-established biomechanical testing model with a complete longitudinal tear 3 mm from the periphery of the meniscus. Sixty specimens were used. One suture was tested at a time. During cyclic testing 100 load cycles were applied with a crosshead speed of 50 mm/min. Three different maximum loads (10 N, 20 N, and 40 N) were used. The preload was set at 5 N. After cyclic loading, the specimens were loaded until failure. During cyclic loading, a gap appeared between the two parts of the meniscus, and partial tissue failures were observed at the surface of the meniscus. Gapping was more marked with higher loads and with the weaker suture material (p < 0.001). Using PDS 0 and PDS 1 sutures, less partial tissue failures were observed compared to PDS 2-0 (p < 0.001). The ultimate failure loads after cyclic loading were higher with PDS-0 and PDS-1 sutures. With these suture materials vertical sutures were stronger than horizontal sutures (p < 0.05). Using PDS 2-0 this difference could not be found. These results show that the primary strength of meniscal sutures depends on the suture material. The frequency and the amount of gapping and partial tissue failures, which can be observed under cyclic loading, are less distinct with PDS-0 and PDS-1 compared to PDS 2-0. From a biomechanical point of view, PDS 0 and PDS 1 sutures are recommended for meniscal sutures to guarantee a high primary stability, a small amount of gapping, and few partial tissue failures.

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“…Barber u. Herbert [7] geben für die Horizontalnaht 55,9 N und für die Vertikalnaht 81,6 N (einfach) sowie 113,3 N (doppelt) an. Andere Autoren geben für die einfache Vertikalnaht Werte zwischen 58,3 N und 113,9 N sowie für die Horizontalnaht zwischen 29,3 N und 75,1 N an [2,9,12,20,27,31]. Der Vergleich dieser Daten zur Festigkeit der Horizontalund Vertikelnaht wird duch die Verwendung unterschiedlicher Fadenstärken und -materialien erschwert (Maxon 0 [2], Ti-Cron 2-0 [9], Ethibond 2-0/3-0 [12,20,27],Vicryl 2-0 [20], PDS 1-0 [31]).…”

Section: Ausreißkraft Der Meniskusankerunclassified

“…Unter "meniscal repair" fanden sich 364 Literaturangaben. Unter diesen 364 Publikationen fanden sich 10 Veröffentlichun-gen zum Stichwort "arrow" [3,2,9,10,12,14,16,22,31,36] Bei den meisten Implantaten wird die Adaptation des Meniskusrisses über Widerhaken am Implantatschaft erzielt "Meniscus Arrow", (Bionx),"Biostinger" (Linvatec), "Meniscus Dart" (Arthrex), "SD Sorb" (Surgical Dynamics). Bei einem anderen Implantat handelt sich um eine kopflose Schraube mit unterschiedlich steilen Gewindegängen Clearfix (Innovasive Devices).…”

Section: Introductionunclassified

Meniskusrefixierung: Faden oder Anker?

et al. 2001

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Suture techniques are the standard for fixation of meniscus bucket-handle lesions. In 1993 a new method for meniscus repair with self-reinforced biodegradable "arrows" was introduced. Currently, various meniscus implants are available in Germany and are widely used clinically. The purpose of this paper was to evaluate and discuss the literature on biodegradable meniscus implants. Relevant articles were retrieved from Medline of the National Library of Medicine (1966 until July 2000) using the combined search strategy for the keywords "meniscal repair" and "arrow." Ten publications were found. The reported advantages of meniscus arrows are the reduced operation time, the easy surgical technique, and the reduced risk of neurovascular injury. In most experimental studies, lower failure strength of meniscus arrows was found compared to meniscus sutures. In clinical studies, the meniscal healing rates comparing the arrow technique and suture technique are comparable. Various complications of the new arrow technique have been reported such as inflammatory foreign-body reaction, cartilage lesions, and arrow displacement. Based on the existing literature, no final judgment is possible. Currently, individual indications depending on the kind of meniscal lesion and location are recommended. A combination of suture and arrow technique might be a treatment option, but further prospective randomized studies and longer follow-ups are necessary.

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Failure strengths of suture versus biodegradable arrow for meniscal repair: an in vitro study

Cited by 132 publications

References 16 publications

Meniscus tear surgery and meniscus replacement

Meniscus tear surgery and meniscus replacement

Der Einfluss verschiedener Nahtstärken auf das Verhalten von Meniskusnähten unter zyklischer Zugbelastung

Meniskusrefixierung: Faden oder Anker?

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