scholarly journals Tacks vs. sutures: a biomechanical analysis of sacral bony fixation methods for laparoscopic apical fixations in the porcine model

2021 ◽  
Author(s):  
Alina Katharina Jansen ◽  
Sebastian Ludwig ◽  
Wolfram Malter ◽  
Axel Sauerwald ◽  
Jens Hachenberg ◽  
...  
Keyword(s):  
Failure Mode ◽  
Reference Group ◽  
Maximum Load ◽  
Biomechanical Properties ◽  
Biomechanical Analysis ◽  
Fixation Method ◽  
Anterior Longitudinal Ligament ◽  
Fixation Methods ◽  
Fresh Cadaver ◽  
Significant Difference

Abstract Purpose There is a novel surgical procedure, called cervicosacropexy (CESA) and vaginosacropexy (VASA) to treat pelvic organ prolapse and a concomitant urgency and mixed urinary incontinence. As there is little experience with the tapes so far and literature is scanty, the aim of this study was to investigate biomechanical properties for the fixation of the PVDF-tapes with three different fixation methods in context of apical fixations. Methods Evaluation was performed on porcine, fresh cadaver sacral spines. A total of 40 trials, divided into 4 subgroups, was performed on the anterior longitudinal ligament. Recorded biomechanical properties were displacement at failure, maximum load and stiffness in terms of the primary endpoints. The failure mode was a secondary endpoint. Group 4 was a reference group to compare single sutures on porcine tissue with those on human tissue. Biomechanical parameters for single sutures on the human anterior longitudinal ligament were evaluated in a previous work by Hachenberg et al. Results The maximum load for group 1 (two single sutures) was 65 ± 12 N, for group 2 (three titanium tacks arranged in a row) it was 25 ± 10 N and for group 3 (three titanium tacks arranged in a triangle) it was 38 ± 12 N. There was a significant difference between all three groups. The most common failure mode was a “mesh failure” in 9/10 trials for groups 1–3. Conclusion The PVDF-tape fixation with two single sutures endures 2.6 times more load than titanium tacks arranged in a row and 1.7 times more load than titanium tacks arranged in a triangle. The presacral fixation with titanium tacks reduced surgical time compared to the fixation with sutures, nevertheless sutures represent the significantly stronger and cheaper fixation method.

scholarly journals A biomechanical analysis of different meshes for reconstructions of the pelvic floor in the porcine model

2021 ◽  
Author(s):  
Nadja Trageser ◽  
Axel Sauerwald ◽  
Sebastian Ludwig ◽  
Wolfram Malter ◽  
Kilian Wegmann ◽  
...  
Keyword(s):  
Porcine Model ◽  
Biomechanical Testing ◽  
Surgical Techniques ◽  
Maximum Load ◽  
Apical Part ◽  
Biomechanical Analysis ◽  
Fixation Method ◽  
Surgical Approaches ◽  
Fresh Cadaver ◽  
Significant Difference

Abstract Purpose Many different surgical approaches have been established for the repair of a pelvic organ prolapse. Especially in laparoscopic surgery, it is important to generate easy surgical techniques with similar stability. This study shall simplify the choice of mesh by evaluating three polypropylene meshes regarding their biomechanical properties. Methods Biomechanical testing was performed in the porcine model. The meshes are fixated on porcine fresh cadaver cervices after subtotal hysterectomy. The apical part of the mesh is fixated with parallel screw clamps at the testing frame. Forty-one trials were performed overall, subdivided into four subgroups. The groups differ in mesh type and fixation method. Maximum load, displacement at failure and stiffness parameters were evaluated with an Instron 5565® test frame. Results SERATEX® E11 PA (E11) showed the highest values for maximum load (199 ± 29N), failure displacement (71 ± 12 mm) and stiffness (3.93 ± 0.59 N/mm). There was no significant difference in all three evaluated parameters between SERATEX® B3 PA (B3) and SERATEX® SlimSling® with bilateral fixation (SSB). SERATEX® SlimSling® with unilateral fixation (SSU) had the lowest stiffness (0.91 ± 0.19 N/mm) and maximum load (30 ± 2 N) but no significant difference in displacement at failure. Conclusion All meshes achieved a good tensile strength, but the results of maximum load show that the E11 is superior to the other meshes. Through a bilateral fixation of SERATEX® SlimSling®, a simple operating method is generated without a loss of stability.

scholarly journals Biomechanical Analysis of All-Suture Anchor Fixation for Rotator Cuff Repair

2018 ◽  
Vol 6 (7_suppl4) ◽  
pp. 2325967118S0017 ◽  
Author(s):  
Eamon Bernardoni ◽  
Rachel M. Frank ◽  
Shreya S. Veera ◽  
Justin W. Griffin ◽  
Brian Robert Waterman ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Failure Mode ◽  
Rotator Cuff Repair ◽  
Suture Anchor ◽  
Maximum Load ◽  
Biomechanical Properties ◽  
Matched Pair ◽  
Pull Out ◽  
Significant Difference ◽  
Cuff Repair

Objectives: Suture anchors are commonly utilized during arthroscopic rotator cuff repair (RCR). Recently, all-suture suture-anchor (ASSA) constructs have been introduced for RCR; however, the biomechanical properties of these implants are poorly understood. The purpose of this study was to compare the biomechanical properties of ASSA to conventional suture anchor (CSA) fixation during RCR. Methods: Fourteen fresh-frozen matched pair human cadaveric shoulders (average age 52 ± 13 years) with no documented prior rotator cuff tears or shoulder surgery were dissected. The supraspinatous tendon was isolated and detached from its footprint, and then was repaired in an anatomical position. Specimens were randomized into two repair constructs: Q-FIX double-loaded ASSA (N=7) and TWINFIX double-loaded conventional suture anchor (CSA) (N=7) (Smith & Nephew, Andover, MA). Each construct was cyclically loaded from 10 to 160 N for 100 cycles at 100N/s, and then pulled to failure at 1mm/s starting from the zero position. Load, crosshead displacement, failure mode, and time were recorded. Correlations between BMD, tendon gage length, maximum load, and stiffness were assessed. The groups were statistically analyzed with independent samples t-test, Fisher’s exact test, and a linear regression analysis, with p<0.05 considered significant. Results: There was no statistically significant difference in maximum load (ASSA: 617.73±177.8, CSA: 545.13±212.98 N, p=0.339), cyclic extension (ASSA: 7.88±1.33, CSA: 8.49±2.14 mm, p=0.117), construct stiffness (ASSA: 62.43±11.06, CSA: 68.14±10.77 N/mm, p=0.973), or extension at maximum load (ASSA: 17.03±4.73, CSA: 15.45±1.73 mm, p=0.122) between the ASSA and CSA groups. Failure modes consisted of suture tearing out of the tendon (ASSA: N=3, CSA: N=3) and anchor pull out (ASSA: N=4, CSA: N=4), with no difference in failure mode between groups (p=0.99). An association trended towards significance between higher BMD and higher maximum load in the CSA group (p=0.053) but not the ASSA group (p=0.125) Conclusion: ASSA constructs for RCR have similar biomechanical properties compared to CSA constructs. Additional clinical data is necessary to determine if these biomechanical results can be translated clinically.

scholarly journals Biomechanical properties of a novel biodegradable magnesium-based interference screw

2016 ◽  
Vol 8 (2) ◽  
Author(s):  
Marco Ezechieli ◽  
Hanna Meyer ◽  
Arne Lucas ◽  
Patrick Helmecke ◽  
Christoph Becher ◽  
...  
Keyword(s):  
Cruciate Ligament ◽  
Testing Machine ◽  
Biomechanical Testing ◽  
Maximum Load ◽  
Biomechanical Properties ◽  
Interference Screw ◽  
Biomechanical Analysis ◽  
Interference Screws ◽  
Standard Implant ◽  
Biodegradable Magnesium

Magnesium-based interference screws may be an alternative in anterior/posterior cruciate ligament reconstruction. The well-known osteoconductive effects of biodegradable magnesium alloys may be useful. It was the purpose of this study to evaluate the biomechanical properties of a magnesium based interference screw and compare it to a standard implant. A MgYREZr-alloy interference screw and a standard implant (Milagro®; De Puy Mitek, Raynham, MA, USA) were used for graft fixation. Specimens were placed into a tensile loading fixation of a servohydraulic testing machine. Biomechanical analysis included pretensioning of the constructs at 20 N for 1 min following cyclic pretensioning of 20 cycles between 20 and 60 N. Biomechanical elongation was evaluated with cyclic loading of 1000 cycles between 50 and 200 N at 0.5 Hz. Maximum load to failure was 511.3±66.5 N for the Milagro® screw and 529.0±63.3 N for magnesium-based screw (ns, P=0.57). Elongations after preload, during cyclical loading and during failure load were not different between the groups (ns, P&gt;0.05). Stiffness was 121.1±13.8 N/mm for the magnesiumbased screw and 144.1±18.4 for the Milagro® screw (ns, P=0.32). MgYREZr alloy interference screws show comparable results in biomechanical testing to standard implants and may be an alternative for anterior cruciate reconstruction in the future.

Cyclic Testing of Flexible All-Inside Meniscus Suture Anchors: Biomechanical Analysis

2005 ◽  
Vol 33 (3) ◽  
pp. 388-394 ◽  
Author(s):  
Thore Zantop ◽  
Ann K. Eggers ◽  
Volker Musahl ◽  
Andre Weimann ◽  
Wolf Petersen
Keyword(s):  
Cyclic Loading ◽  
Biomechanical Properties ◽  
Meniscus Repair ◽  
Biomechanical Analysis ◽  
Suture Techniques ◽  
Suture Anchors ◽  
Pull Out ◽  
Meniscus Suture ◽  
Significant Difference ◽  
Pull Out Strength

Background Flexible meniscus repair devices are designed to combine the benefits of rigid all-inside meniscus anchors with the biomechanical properties of sutures. Hypothesis Stiffness and pull-out strength of flexible all-inside suture anchors and conventional sutures under cyclic loading conditions will be comparable. Study Design Controlled laboratory study Methods In 50 fresh frozen bovine menisci, artificial meniscus lesions were repaired with different meniscus fixation techniques: horizontal and vertical FasT-Fix, RapidLoc, and horizontal and vertical 2-0 Ethibond sutures. The specimens were cycled 1000 times between 5 and 20 N and then loaded to failure. Results All devices survived the cyclic loading protocol. There was no significant difference in the displacement between all repair techniques tested (horizontal FasT-Fix, 6.23 mm; vertical FasT-Fix, 5.34 mm; RapidLoc, 6.84 mm; horizontal 2-0 Ethibond, 6.03 mm; vertical 2-0 Ethibond, 5.61 mm (P >. 05). Vertical and horizontal FasT-Fix suture anchors had a significantly higher stiffness and pull-out strength (94.1 N and 80.8 N, respectively) than did horizontal sutures (50.2 N) and RapidLoc devices (30.3 N) (P >. 05). Conclusions In this study, flexible all-inside meniscus anchors (FasT-Fix) had higher pull-out strength than did conventional vertical suture techniques. Biomechanical characteristics of the flexible RapidLoc are comparable to those of horizontal sutures. Clinical Relevance Flexible all-inside meniscus repair devices are an alternative to conventional suture techniques.

Biomechanical properties of expander compared with conventional screws

2002 ◽  
Vol 97 (3) ◽  
pp. 346-349 ◽  
Author(s):  
Aziz Rassi-Neto ◽  
Antonio Shimano
Keyword(s):  
Maximum Load ◽  
Biomechanical Properties ◽  
Biomechanical Study ◽  
Intergroup Difference ◽  
Content Type ◽  
Significant Difference ◽  
Group 2 ◽  
The Comparative Study ◽  
Screw Group ◽  
Fine Print

Object. A pullout strength biomechanical study was performed in 20 fresh swine vertebral bodies in which titanium expander (Group 1) and conventional screws (Group 2) were placed. Methods. The screws were inserted into the anterosuperior portion of the anterior spine, and assessment was performed after application of loads. The expander screw is composed of two parts: 1) a cover with an external portion comprising tight thin threads; and 2) a compact internal screw inserted through the cover that allows expansion. In the comparative study between the screws in Groups 1 and 2 maximum load was assessed, and the intergroup difference was significant (p = 0.00001 [t-test]); regarding load at the elasticity threshold, a significant difference was also observed (p = 0.0063). With regard to rigidity (stiffness), there was a tendency in both groups toward significance (p = 0.069). With regard to absorbed energy in the elastic phase, statistical analysis showed a significant intergroup difference (p = 0.00439). The expander screw showed a greater load-bearing capacity than the conventional screw. Adhesion to bone in relation to the applied load and displacement was greater (significant tendency) in the expander screw group than in the conventional screw group. Conclusions. The expander screws exhibited a greater capacity to absorb energy in the elastic phase. They adhered better to bone, were easy to insert, and, if necessary, were simple to remove.

Ultimate Load Measuring System for Fixation of Soft Tissue to Bone

2021 ◽  
pp. 107110072110405
Author(s):  
Tatsuya Fujii ◽  
Makoto Tateura ◽  
Masato Ogawa ◽  
Satoru Ozeki
Keyword(s):  
Animal Model ◽  
Experimental Animal ◽  
Ultimate Load ◽  
Testing Machine ◽  
Graft Fixation ◽  
Experimental Animal Model ◽  
Fixation Method ◽  
Lateral Ankle ◽  
Fixation Methods ◽  
Significant Difference

Background: The initial ultimate load for graft fixation is one of the essential factors in the reconstruction of lateral ankle ligaments. Several anchoring devices have been developed to fix the substitute ligament into the bone. A fair comparison of these fixation methods warrant a reproducible examination system. The purpose of this study was to make an experimental animal model and to compare the initial ultimate loads of 3 graft fixation methods, including the use of EndoButton (EB), interference screw (IFS), and a novel socket anchoring (SA) technique. Methods: Porcine calcaneus bones and 5-mm-wide split bovine Achilles tendons were used as fixation bases and graft materials, respectively. Both ends were firmly sutured side-by-side, using the circumferential ligation technique as a double-strand substitute that was 45 mm in length. Porcine calcanei with similar characteristics to adult human calcanei were mounted on a tensile testing machine, and substitutes were fixed into bones using the 3 fixation methods. A polyester tape was passed through the tendon loop and connected to a crosshead jig of the testing machine. The initial ultimate loads were measured in 15 specimens for each fixation method to simulate a lateral ankle ligament (LAL) injury. Results: The ultimate loads (ULs) were 223.6 ± 52.7 N for EB, 229.7 ± 39.7 N for SA, and 208.8 ± 65.3 N for IFS. No statistically significant difference was observed among the 3 groups ( P = .571). All failures occurred at the bone–ligament substitute interface. Conclusion: The initial ULs in all 3 fixation methods were sufficient for clinical usage. These values were larger than the UL of the anterior talofibular ligament; however, these were smaller than the UL of the calcaneofibular ligament. Clinical Relevance: In an experimental animal model, ULs for SA, EB, and IFS techniques showed no significant difference. All failures were observed in the fixation site of the calcaneus and were overwhelmingly related to suture fixation failure.

Mechanical Strength of Scaphoid Fixation

1996 ◽  
Vol 21 (1) ◽  
pp. 99-102 ◽  
Author(s):  
M. L. NEWPORT ◽  
C. D. WILLIAMS ◽  
W. D. BRADLEY
Keyword(s):  
Mechanical Strength ◽  
Failure Mode ◽  
Biomechanical Properties ◽  
Failure Strength ◽  
Cannulated Screws ◽  
Compression Screw ◽  
Universal Compression ◽  
Significant Difference ◽  
Ultimate Failure ◽  
Cantilever Bending

We have investigated five devices suitable for scaphoid fixation (ASIF 2.7 mm and 3.5 mm cannulated screws, Herbert, Herbert-Whipple, and Howmedica Universal Compression Screw). The biomechanical properties tested were compression and resistance to cantilever bending. There was no statistically significant difference in compression between devices. There were significant differences in resistance to cantilever bending, with the Howmedica screw being strongest in both failure mode and in ultimate failure strength.

A Biomechanical Comparison of Composite Fixation and Veterinary Acetabular Plates for Stabilization of Acetabular Osteotomies in Dogs Loaded in Three-Point-Bending Fashion

1998 ◽  
Vol 11 (03) ◽  
pp. 152-157 ◽  
Author(s):  
D. D. Lewis ◽  
J. B. Madison ◽  
L. L. Blaeser ◽  
O. I. Ianz
Keyword(s):  
Yield Point ◽  
In Vitro Study ◽  
Maximum Load ◽  
Fixation Method ◽  
Three Point Bending ◽  
Mixed Breed ◽  
Significant Difference ◽  
Biomechanical Comparison ◽  
In Vitro Comparison

SummaryAn in vitro study comparing the biomechanical performance and accuracy of reduction for two methods of acetabular osteotomy repair in the dog is presented. Pelves were harvested from five adult mixed breed dogs weighing 25-30 kg. On e hemipelvis from each dog was repaired with the composite fixation and the contralateral hemipelvis was repaired with a 2.0 mm six hole veterinary acetabular plate. Eac h hemipelvis was loaded in a threepoint- bending fashion at a rate of 5 mm/min. An extensometer was placed over the dorso-medial surface of the acetabular osteotomy during loading. Reduction was significantly better for hemipelves stabilized with the composite fixation when compared to hemipelves stabilized with the 2.0 mm six hole veterinary acetabular plate. There was not a significant difference in bending stiffness, distractional stiffness, yield point and maximum load between repair groups.An in vitro comparison was made between a composite fixation method and acetabular plates for the stabilisation of acetabular osteotomies.

Biomechanical Evaluation of Suture Configurations in Lesser Toe Plantar Plate Repairs

2018 ◽  
Vol 39 (7) ◽  
pp. 836-842 ◽  
Author(s):  
Fred T. Finney ◽  
Simon Lee ◽  
Jaron Scott ◽  
Todd A. Irwin ◽  
James R. Holmes ◽  
...  
Keyword(s):  
Proximal Phalanx ◽  
Peak Load ◽  
Biomechanical Properties ◽  
Biomechanical Analysis ◽  
Plantar Plate ◽  
Significant Difference ◽  
Load To Failure ◽  
Fresh Frozen ◽  
Human Cadavers ◽  
Number Of Cycles

Background: Lesser toe metatarsal-phalangeal (MTP) joint instability can be a major source of pain and dysfunction. Instability occurs when there is incompetence of the plantar plate and/or collateral ligaments. Newer operative treatments focus on performing anatomic repairs of the plantar plate. The goal of this study was to compare the biomechanical properties of 3 suture configurations that may be used for plantar plate repairs. Methods: Biomechanical analysis of 27 lesser toe plantar plates from fresh frozen human cadavers was completed. The plantar plate was detached from the proximal phalanx, and suture was placed in the distal plantar plate in a horizontal mattress, luggage-tag, or Mason-Allen suture configuration. Cyclic loading followed by load-to-failure testing was performed. Results: There was a significant difference in peak load-to-failure force between constructs (mattress: 115.53 ± 15.95 N; luggage-tag 102.42 ± 19.33 N; Mason-Allen: 89.96 ± 15.78 N; P = .015). Post hoc analysis demonstrated that the mattress configuration had significantly higher load-to-failure force compared with the Mason-Allen configuration ( P = .004). There were no significant differences between the mattress and the luggage-tag configurations or the luggage-tag and the Mason-Allen configurations. There were no differences in construct stiffness, axial displacement at the time of failure, or number of cycles required to produce 2 mm of displacement. Conclusion: The mattress configuration demonstrated better peak load-to-failure force compared with the Mason-Allen configuration but was not statistically different from the luggage-tag configuration. Although not significant, the mattress configuration trended toward higher load-to-failure force compared with the luggage-tag. Clinical Relevance: The horizontal mattress stitch may be the biomechanically superior configuration in plantar plate repairs.

INFLUENCE OF PLATELET RICH FIBRIN ON BIOMECHANICAL PROPERTIES OF PRIMARY SUTURED CUTANEOUS INCISIONAL WOUNDS

2016 ◽  
Vol 42 (02) ◽  
pp. 69-74 ◽  
Author(s):  
Vahid Mirzazadeh Dizaji ◽  
Davoud Kazemi ◽  
Mostafa Rezaei
Keyword(s):  
Vertebral Column ◽  
Venous Blood ◽  
Biomechanical Properties ◽  
Biomechanical Analysis ◽  
Platelet Rich Fibrin ◽  
Mixed Breed ◽  
Significant Difference ◽  
The Right ◽  
And Control ◽  
Skin Samples

The aim of the present study was to investigate the effect of platelet rich fibrin (PRF), a second generation platelet concentrate, on biomechanical properties of primary sutured cutaneous incisional wounds. Acute incisional wounds were made on the right and left side of the vertebral column of 15 adult mixed breed dogs. PRF membrane prepared from the venous blood of each animal was placed between the edges of the left side incisions while the right side incisions were used as controls. All incisions were sutured and skin samples were taken on days 3, 7 and 14 post-wounding for biomechanical analysis of wound strength. Mean breaking and tensile strength of PRF treated wounds were 48% and 52% greater than the control wounds at day 7 respectively which was statistically significant. Mean breaking stress of PRF treated wounds was also significantly greater than the controls at day 3 (16.42[Formula: see text][Formula: see text][Formula: see text]7.73 versus 9.823[Formula: see text][Formula: see text][Formula: see text]6.018). No significant difference in Young’s modulus of elasticity was observed between the treatment and control wounds. The results demonstrate that PRF improves the biomechanical properties of the healing incisional wounds especially in the first week. This could have positive implications particularly in patients suffering from conditions which adversely affect wound healing such as diabetes both in animals and humans although further studies are required.

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