Advanced search
1 file | 418.98 KB

What is the best way to fix a polyurethane meniscal scaffold?: a biomechanical evaluation of different fixation modes

Author
Organization
Abstract
Ingrowth of meniscal tissue into a meniscal scaffold can be optimized by securely fixing the scaffold into the meniscal remnants. The purpose of this research was to test and compare commonly used suture types and suture materials to fix a meniscal scaffold. Forty fresh porcine menisci were used. All tests used the same polyurethane-based scaffold. The load to failure of horizontal, vertical and diagonal sutures with PDS 0 and with Ethibond 0, and diagonal sutures with Ultra Fast-Fix(A (R)) and Sequent(A (R)) to fix a meniscal scaffold were tested. Five tests were conducted for each configuration. All constructs failed in the scaffold at a mean pullout force of 50.6 N (SD 12.7). Inferior results were noted for vertical sutures (40.1 N, SD 6.3) compared to horizontal (49.8 N, SD 5.5, p = 0.0007) and diagonal (51.7 N, SD 15.6, p = 0.024) sutures and for Ethibond 0 (41.4 N, SD 6.2) compared to PDS 0 (51.3 N, SD 12.9, p = 0.001). When comparing the diagonal suture placements, only Ethibond 0 (42.9 N, SD 5.4) showed significantly inferior results compared to PDS 0 (60.1 N, SD 16.9, p = 0.03), Ultra Fast-Fix(A (R)) (60.1 N, SD 9.3, p = 0.004) and Sequent(A (R)) (65.8 N, SD 4.4, p < 0.0001). The most common failure mode when fixing a polyurethane-based meniscal scaffold is suture pull-through of the scaffold in the distraction mode. This happens at a rather low pullout force and might preclude the use of this scaffold clinically. Vertical sutures and Ethibond 0 multifilament braided sutures fail at lower forces, and the tested commercial devices show promising results.
Keywords
Biomechanical study, Meniscal suture, 2-YEAR FOLLOW-UP, MEDIAL MENISCUS, REPAIR TECHNIQUES, FAILURE STRENGTH, SUTURE TECHNIQUE, POSTERIOR HORN, IN-VITRO, LESIONS, TRANSPLANTATION, MENISCECTOMY, Implantation, Meniscal scaffold

Downloads

  • (...).pdf
    • full text
    • |
    • UGent only
    • |
    • PDF
    • |
    • 418.98 KB

Citation

Please use this url to cite or link to this publication:

Chicago
Hardeman, François, Kristoff Corten, Michiel Mylle, Bert Van Herck, René Verdonk, Peter Verdonk, and Johan Bellemans. 2015. “What Is the Best Way to Fix a Polyurethane Meniscal Scaffold?: a Biomechanical Evaluation of Different Fixation Modes.” Knee Surgery Sports Traumatology Arthroscopy 23 (1): 59–64.
APA
Hardeman, F., Corten, K., Mylle, M., Van Herck, B., Verdonk, R., Verdonk, P., & Bellemans, J. (2015). What is the best way to fix a polyurethane meniscal scaffold?: a biomechanical evaluation of different fixation modes. KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, 23(1), 59–64.
Vancouver
1.
Hardeman F, Corten K, Mylle M, Van Herck B, Verdonk R, Verdonk P, et al. What is the best way to fix a polyurethane meniscal scaffold?: a biomechanical evaluation of different fixation modes. KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY. 2015;23(1):59–64.
MLA
Hardeman, François et al. “What Is the Best Way to Fix a Polyurethane Meniscal Scaffold?: a Biomechanical Evaluation of Different Fixation Modes.” KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY 23.1 (2015): 59–64. Print.
@article{7037519,
  abstract     = {Ingrowth of meniscal tissue into a meniscal scaffold can be optimized by securely fixing the scaffold into the meniscal remnants. The purpose of this research was to test and compare commonly used suture types and suture materials to fix a meniscal scaffold. 
Forty fresh porcine menisci were used. All tests used the same polyurethane-based scaffold. The load to failure of horizontal, vertical and diagonal sutures with PDS 0 and with Ethibond 0, and diagonal sutures with Ultra Fast-Fix(A (R)) and Sequent(A (R)) to fix a meniscal scaffold were tested. Five tests were conducted for each configuration. 
All constructs failed in the scaffold at a mean pullout force of 50.6 N (SD 12.7). Inferior results were noted for vertical sutures (40.1 N, SD 6.3) compared to horizontal (49.8 N, SD 5.5, p = 0.0007) and diagonal (51.7 N, SD 15.6, p = 0.024) sutures and for Ethibond 0 (41.4 N, SD 6.2) compared to PDS 0 (51.3 N, SD 12.9, p = 0.001). When comparing the diagonal suture placements, only Ethibond 0 (42.9 N, SD 5.4) showed significantly inferior results compared to PDS 0 (60.1 N, SD 16.9, p = 0.03), Ultra Fast-Fix(A (R)) (60.1 N, SD 9.3, p = 0.004) and Sequent(A (R)) (65.8 N, SD 4.4, p < 0.0001). 
The most common failure mode when fixing a polyurethane-based meniscal scaffold is suture pull-through of the scaffold in the distraction mode. This happens at a rather low pullout force and might preclude the use of this scaffold clinically. Vertical sutures and Ethibond 0 multifilament braided sutures fail at lower forces, and the tested commercial devices show promising results.},
  author       = {Hardeman, François and Corten, Kristoff and Mylle, Michiel and Van Herck, Bert and Verdonk, René and Verdonk, Peter and Bellemans, Johan},
  issn         = {0942-2056},
  journal      = {KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY},
  keywords     = {Biomechanical study,Meniscal suture,2-YEAR FOLLOW-UP,MEDIAL MENISCUS,REPAIR TECHNIQUES,FAILURE STRENGTH,SUTURE TECHNIQUE,POSTERIOR HORN,IN-VITRO,LESIONS,TRANSPLANTATION,MENISCECTOMY,Implantation,Meniscal scaffold},
  language     = {eng},
  number       = {1},
  pages        = {59--64},
  title        = {What is the best way to fix a polyurethane meniscal scaffold?: a biomechanical evaluation of different fixation modes},
  url          = {http://dx.doi.org/10.1007/s00167-013-2495-y},
  volume       = {23},
  year         = {2015},
}

Altmetric
View in Altmetric
Web of Science
Times cited: