Assessment of mechanical properties and dimensions of suture threads utilized in orthopedic surgeries (original) (raw)
Material properties of common suture materials in orthopaedic surgery
The Iowa orthopaedic journal, 2010
Suture materials in orthopaedic surgery are used for closure of wounds, repair of fascia, muscles, tendons, ligaments, joint capsules, and cerclage or tension band of certain fractures. The purpose of this study was to compare the biomechanical properties of eleven commonly used sutures in orthopaedic surgery. Three types of braided non-absorbable and one type of braided absorbable suture material with different calibers (n=77) underwent biomechanical testing for maximum load to failure, strain, and stiffness. All samples were tied by one surgeon with a single SMC (Seoul Medical Center) knot and three square knots. The maximum load to failure and strain were highest for #5 FiberWire and lowest for #0 Ethibond Excel (p<0.001). The stiffness was highest for #5 FiberWire and lowest for #2-0 Vicryl (p<0.001). In all samples, the failure of the suture material occurred at the knot There was no slippage of the knot in any of the samples tested. This data will assist the orthopaedic ...
Handling characteristics of braided suture materials for tight tying
Journal of Applied Biomaterials, 1993
To establish criteria for characterizing synthetic sutures, the handling characteristics of silk suture were analyzed. The characteristics that distinguish silk suture from other braided suture materials are its good "knot security" and relatively low "tiedown resistance." Analytic consideration of knot security suggests that not only superficial friction but also resistance force produced by cross-sectional deformity of braided threads plays an important role in silk's superior performance. Results of a "pullout friction test," developed to quantitatively evaluate resistance produced by surface friction and cross-sectional deformity suggest that the superiority of silk thread can be explained in terms of high static withdrawal resistance under low loads and relatively low dynamic withdrawal resistance under high loads.
Veterinary Surgery, 2010
Objective-To evaluate the effect of 6 different knotting methods on the mechanical properties of 3 large absorbable suture materials used in large animal surgery. Study Design-In vitro mechanical study. Sample Population-Knotted suture loops (n=15 per group). Methods-Suture loops were created between two low-friction pulleys with either 2 polydioxanone, 2 polyglactin 910 or 3 polyglactin 910. Strands were tied using 1 of 6 knotting technique: square knot, surgeon knot, clamped surgeon's knot, sliding half-hitch knot (HH), Delimar knot and self-locking knot (SLK). A single cycle to failure test was performed on each suture loop with a distraction rate of 100 mm/min. Failure modes were evaluated and breaking strength, elongation to failure and stiffness were compared. Results-All loops except two HH failed at the knot by acute breaking. The double-stranded SLK was both stronger and stiffer than all other knots for each suture material. Clamping the first throw of the surgeon knot decreased load to failure significantly (143.11 AE 8.64 N) compared with not clamping (159.21 AE 6.14 N) for polydioxanone. Stiffness and elongation to failure were respectively lower and increased for 2 polydioxanone compared with both polyglactin 910 materials for all knotting techniques. Conclusions-Knotting techniques do influence structural properties of suture loops. The double strand loop conferred stiffer and stronger properties to the SLK Clinical Relevance-Clamping the first throw of polydioxanone should be avoided when tying a suture under tension even using large diameter suture materials. Using a SLK might be considered as a useful alternative when excessive tension is present.
Journal of Orthopaedic Research, 2013
In orthopedic surgery, the reattachment of tendon to bone requires suture materials that have stable and durable properties to allow time for healing at the tendon-bone interface. The suture, not rigidly restrained within the anchor eyelet, is free to move during surgery and potentially after surgery with limb motion. During such movement, the suture is subjected to bending and frictional forces that can lead to fatigue-induced failure. We investigated some common contemporary commercial number-two-grade suture materials and evaluated their resistance to bending abrasion fatigue and the consequent failure. Sutures were oscillated over a stainless steel wire at low frequency under load. Number of abrasion cycles to failure, changes in suture morphology, and fatigue-failure method was recorded for each material. Suture structure had a significant effect on abrasion resistance, with braided sutures containing large numbers of fine high tenacity core filaments performing15-20 times better than other braided suture structures. Ultra high molecular weight polyethylene (UHMWPE) core filaments resisted bending abrasion failure better than other core materials due to the load spreading and abrasion resistance of these filaments. Sutures with UHMWPE cores also had high resistance to tensile failure. Limited correlation was observed between tensile strength and abrasion resistance. ß
Knee Surgery, Sports Traumatology, Arthroscopy, 2004
Bibliothéque nationale du Canada Acquisitions and Acquisitions et Bibliographie Services services bibliographiques 395 Wellington Street 395. nre Wellingtm O(tawa0N K l A O N 4 OMwa ON K I A ON4 Canada Canada The author has granted a nonexclusive Licence allowing the National Library of Canada to reproduce, loan, distribute or sel1 copies of this thesis in microfonn, paper or electronic formats. The author retains ownership of the copyright in this thesis. Neither the thesis nor substantial extracts fiom it may be printed or othenvise reproduced without the author's permission. TEE UlMVERSITY OF MANITOBA FACULTY OF GRADUATE STUDIES
Polymers, 2016
The aim of this study was to evaluate and compare the mechanical properties of five suture materials on three knot configurations when subjected to different physical conditions. Five 5-0 (silk, polyamide 6/66, polyglycolic acid, glycolide-e-caprolactone copolymer, polytetrafluoroethylene) suture materials were used. Ten samples per group of each material were used. Three knot configurations were compared A.2=1=1 (forward-forward-reverse), B.2=1=1 (forward-reverse-forward), C.1=2=1 (forward-forward-reverse). Mechanical properties (failure load, elongation, knot slippage/breakage) were measured using a universal testing machine. Samples were immersed in three different pH concentrations (4,7,9) at room temperature for 7 and 14 days. For the thermal cycle process, sutures were immersed in two water tanks at different temperatures (5 and 55˝C). Elongation and failure load were directly dependent on the suture material. Polyglycolic acid followed by glycolide-e-caprolactone copolymer showed the most knot failure load, while polytetrafluoroethylene showed the lowest (p < 0.001). Physical conditions had no effect on knot failure load (p = 0.494). Statistically significant differences were observed between knot configurations (p = 0.008). Additionally, individual assessment of suture material showed statistically significant results for combinations of particular knot configurations. Physical conditions, such as pH concentration and thermal cycle process, have no influence on suture mechanical properties. However, knot failure load depends on the suture material and knot configuration used. Consequently, specific suturing protocols might be recommended to obtain higher results of knot security.
Effect of Coefficient of Friction and Bending Rigidity on Handling Behaviour of Surgical Suture
Journal of The Institution of Engineers (India): Series E, 2019
The purpose of this study was to provide information on textile behaviour of suture materials in order to assist surgeons in their selection of adequate sutures for specific surgical applications. Commercially available absorbable and non-absorbable (both braided and monofilament) coated sutures of size 2-0 were used in this study. A comparative study between two different manufacturers, i.e. Johnson & Johnson (USA) and Sutures India (India), was also carried out during this work. On the basis of mechanical tests including suture-to-suture coefficient of friction, suture-to-skin coefficient of friction, bending rigidity, handling characteristic, i.e. knot tie-down roughness of suture materials were studied. Obtained results show that among these tests, suture-to-suture coefficient of friction and bending rigidity have significant effect on the handling characteristic of suture. Higher coefficient of friction exhibited by braided suture suggests that, despite of coating, asperities formed on these sutures resulted in their higher friction than monofilament ones.
Mechanical testing of different knot types using high-performance suture material
Knee Surgery, Sports Traumatology, Arthroscopy, 2013
Purpose This laboratory study aimed to evaluate the loop security, knot security, cyclic loading resistance and loadto-failure rate of three different knot types with establishing a new experimental setup. Additionally, the mode of failure of each knot was evaluated. Methods With the use of nonabsorbable, braided polyethylene sutures, USP size No. 2 [Hi-Fi Ò ; ConMed Linvatec], the arthroscopic knot types Dines, SMC as well as the surgeon's knot were tested using a material testing machine. The knots were tied openly as well as arthroscopically. The setup enables testing of knot configurations while eliminating friction between knot loop and its suspension points. Including all test procedures, a total of 216 knots were tested. Results All openly tied knot types and ten of each type of arthroscopically tied knots resisted against cyclic loading of 1,000 cycles. With subsequent load-to-failure testing, openly tied knot types achieved significantly higher values of tensile strength than arthroscopically tied knots. Regarding clinical failure, defined as an elongation of 3 mm, Dines knot reached highest loop as well as knot security. Knot slippage was the most common failure mechanism at an elongation of 3 mm, whereas suture breakage was evaluated most at an elongation of 6 mm. Conclusions The new experimental setup confirms the loop security of arthroscopic knot types. Using a knot pusher clinically is a key factor to attain this as compared to openly hand-tied techniques. The Dines knot presented the highest reliability. It may provide a secure tissue healing during rehabilitation and consequently can be recommended for clinical application.