Influence of Sutures on Cartilage Integrity: Do Meniscus Sutures Harm Cartilage? An Experimental Animal Study

Venjakob, Arne Johannes; Fôhr, P; Henke, Ferdinand; Tischer, Thomas; Sandmann, Gunther H.; Blanke, Fabian; Imhoff, Andreas B.; Milz, Stefan; Burgkart, Rainer; Vogt, Stephan

doi:10.1016/j.arthro.2018.11.040

Cited by 16 publications

(23 citation statements)

References 21 publications

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“…In a previous study utilizing the same preparation detailed above, osteochondral plugs of the same dimensions were also harvested from the femoral condyle (OATS® system, Arthrex, Florida, USA) [40]. Afterwards the tibial osteochondral plugs were cycled against the osteochondral plugs from the opposing femoral condyle in a saline medium for 24, 48, and 72 h as a proof-ofconcept (n = 9).…”

Section: Specimen and Study Designmentioning

confidence: 99%

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Effects of focal metallic implants on opposing cartilage – an in-vitro study with an abrasion test machine

Diermeier

Venjakob

Byrne

et al. 2020

BMC Musculoskelet Disord

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Background: For focal cartilage defects, biological repair might be ineffective in patients over 45 years. A focal metallic implant (FMI) (Hemi-CAP Arthrosurface Inc., Franklin, MA, USA) was designed to reduce symptoms. The aim of this study was to evaluate the effects of a FMI on the opposing tibial cartilage in a biomechanical set-up. It is hypothesized that a FMI would not damage the opposing cartilage under physiological loading conditions. Methods: An abrasion machine was used to test the effects of cyclic loading on osteochondral plugs. The machine applied a compressive load of 33 N and sheared the samples 10 mm in the anteroposterior direction by 1 Hz. Tibial osteochondral plugs from porcine knees were placed in opposition to a FMI and cycled for 1 or 6 h. After testing each plug was fixed, stained and evaluated for cartilage damage. Results: After 1 h of loading (n = 6), none of the osteochondral plugs showed histologic signs of degradation. After 6 h of loading (n = 6) three samples had histologic signs of injury in the tangential zone (grade 1) and one had signs of injury in the transitional and deep zones (grade 2). Exploration for 6 h resulted in significant more cartilage damage compared to the shorter exploration time (p = 0.06). However, no significant difference between saline and hyaluronic acid was evident (p = 0.55). Conclusion: Under physiologic loading conditions, contact with a FMI leads to cartilage damage in the opposing articular cartilage in six hours. In clinical practice, a thorough analysis of pre-existing defects on the opposing cartilage is recommended when FMI is considered.

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Section: Specimen and Study Designmentioning

confidence: 99%

“…As previously described all tests were performed in a specially designed abrasion test machine ( Fig. 1) [40]. In summary the system consisted of a drive mechanism connected to a mobile platform and a fixed base.…”

Section: Liner Friction Testing Systemmentioning

confidence: 99%

Effects of focal metallic implants on opposing cartilage – an in-vitro study with an abrasion test machine

Diermeier

Venjakob

Byrne

et al. 2020

BMC Musculoskelet Disord

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“…As Venjakob et al 5 point out, removing the meniscus leads to articular cartilage degeneration. We have seen numerous articles pointing this out.…”

Section: Catch-22?mentioning

confidence: 99%

“…If one were to purposely design a model to show that a suture could damage articular cartilage, this would be it! Venjakob et al 5 took a cylinder of bone capped with articular cartilage and placed it against the smooth surface of a meniscus or tibial plateau. They applied a perpendicularly oriented force to simulate weight bearing and then cycled this construct for 1 or 6 hours.…”

Section: Catch-22?mentioning

confidence: 99%

“…These stiffer devices were abandoned as a newer generation of all-sutureebased meniscal fixators was developed. Nevertheless, Venjakob et al 5 may still be on to something because damage to the articular cartilage from sutures has previously been reported. 9 Mulberry knots, created from a relatively stiff suture, were arthroscopically placed on the superior surface of the meniscus to act as a buttress and create compression across the tear when the suture ends were tied together.…”

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confidence: 99%

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Editorial Commentary: A Stitch in Time May Save the Meniscus…but Not the Articular Cartilage?

Kurzweil¹

2019

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Early-generation meniscal fixators sometimes caused iatrogenic articular cartilage damage. This resulted in injury to the very structure one tries to preserve when repairing a meniscal tear. Advances in suture-based meniscal implants and all-inside suture devices have allowed us to safely repair meniscal tears, even ones thought previously irreparable, and without the need for a secondary incision. As the techniques for meniscal repair continue to improve, orthopaedic surgeons should be encouraged to consider repair with more complex meniscal tear patterns.

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Tough Adhesive Puncture Sealing Sutures with Swelling Triggered Bioadhesion for Enhanced Wound Closure

Ma,

Nguyen,

Chung‐Tze‐Cheong

et al. 2024

Adv Materials Technologies

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Surgical sutures are gold‐standard wound closure devices. However, they are unable to form a tight seal with surrounding tissues, raising the risks of body fluid leakage and surgical site infection. Additionally, the use of sutures can result in cracking at suture roots, damage and micro‐trauma to soft tissues due to the slicing and compression of suture fibers after their placement. Bioadhesives capable of mimicking natural biological interfaces are appealing alternatives, but they cannot achieve the same level of strength as conventional surgical sutures. Here, a tough adhesive puncture sealing (TAPS) suture, featuring swelling‐triggered bioadhesion to mend the gap between the suture and the surrounding tissues with a soft yet tough adhesive interface is reported. This unique design principle of TAPS sutures is applicable to diverse soft tissues of various defect sizes and can be controlled by modulating the hydrogel swelling kinetics. The advantages of the TAPS sutures for meniscal tear repair and intestine tissue sealing ex vivo, corroborates their favorable applications in managing mechanically active musculoskeletal and gastrointestinal tissues are demonstrated. The design and performance of the TAPS sutures offer extensive possibilities for redesigning surgical tools and developing next‐generation medical devices for wound management and tissue repair.

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Influence of Sutures on Cartilage Integrity: Do Meniscus Sutures Harm Cartilage? An Experimental Animal Study

Cited by 16 publications

References 21 publications

Effects of focal metallic implants on opposing cartilage – an in-vitro study with an abrasion test machine

Effects of focal metallic implants on opposing cartilage – an in-vitro study with an abrasion test machine

Editorial Commentary: A Stitch in Time May Save the Meniscus…but Not the Articular Cartilage?

Tough Adhesive Puncture Sealing Sutures with Swelling Triggered Bioadhesion for Enhanced Wound Closure

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