Belastungsuntersuchungen von arthroskopischen und offenen Knotentypen unter Verwendung von hochfestem, polyfilem Nahtmaterial

Mechanical testing of different knot types using high-performance suture material

by Christian Sachs
Doctoral thesis
Date of Examination:2013-12-16
Date of issue:2013-12-03
Advisor:PD Dr. Mike Herbert Baums
Referee:PD Dr. Martin Wachowski
Referee:Prof. Dr. Rainer Mausberg
Persistent Address: http://dx.doi.org/10.53846/goediss-4191

 

 

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Abstract

English

Abstract 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 set-up. 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 ; 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 set-up 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 set-up 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.
Keywords: Suture knots; Security; Biomechanics; Ultra-high molecular weight polyethylene; Cyclic loading
Schlagwörter: Nahtmaterialtestung; zyklische Belastungen; arthroskopische Knoten; ultra hoch molekulargewichtiges Nahtmaterial
 
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