在生理盐水中收缩的动态自张力缝合线可抵消循环加载造成的环状长度变化

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引用次数: 0

摘要

目的通过评估缝合线环长变化、对循环加载的响应以及间歇性生理盐水浸泡的失效测试,比较一种具有拟议动态自张力特性的缝合线与常用高张力缝合线的生物力学性能。方法研究了 4 种不同缝合线的 6 个线结:3 种高张力缝合线(ORTHOCORD、FiberWire 和 ETHIBOND)以及一种动态自张力缝合线(DYNACORD)。测量环长后,将线结在 37°C 的生理盐水中浸泡 24 小时。重新测量线环长度并进行拉伸测试。记录循环伸长、第一周期偏移和伸长幅度。然后重新浸泡绳结并重新测试。最后,将绳结拉至失效,测量峰值载荷和刚度。结果DYNACORD 环的长度在第一次浸泡后减少了 27%(P = .002),而其他缝合线的长度没有变化(P > .05)。虽然 DYNACORD 环的长度在循环负载测试期间有所增加(P = .009),但在第二次盐水浸泡后,其长度仍比初始长度显著减少(P = .002),而所有其他缝合环都变长了。与其他缝合线相比,ETHIBOND(P = .004)和 ORTHOCORD(P = .002)从第一周期到第二周期测试的周期性伸长明显较小。ETHIBOND 失效时的峰值载荷最低(P = .002)。结论与其他类型的缝合线相比,自张力缝合线显示出动态特性,在生理盐水浴中浸泡时,线环长度会减少。临床意义对于关节镜下的软组织手术来说,结和环的安全性至关重要。缝合线的自张力对其在体内如何与组织相互作用以增加关节镜软组织修复术后的构造稳定性具有影响。
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A Dynamic, Self-Tensioning Suture Contracts in Saline to Counteract Changes in Loop Length From Cyclic Loading

Purpose

To compare the biomechanical performance of a suture with proposed dynamic self-tensioning properties with that of commonly used high-tensile sutures by evaluating suture loop length changes, responses to cyclic loading, and failure testing with intermittent saline soaks.

Methods

Six knots each of 4 different sutures were studied: 3 high-tensile sutures (ORTHOCORD, FiberWire, and ETHIBOND), and a dynamically self-tensioning suture (DYNACORD). After we measured loop length, knots were soaked in 37°C saline for 24 hours. Loop lengths were remeasured and tensile testing was performed. Cyclic elongation, first-cycle excursion, and elongation amplitude were recorded. Knots were then resoaked and retested. Finally, knots were pulled to failure, and peak load and stiffness were measured. Values were compared using nonparametric statistical tests.

Results

DYNACORD loop length decreased by 27% after the first soak (P = .002), whereas the other sutures demonstrated no length change (P > .05). Although DYNACORD loop length increased during cyclic load testing (P = .009), it was still significantly reduced after the second saline soak compared with its initial length (P = .002), whereas all other suture loops had elongated. ETHIBOND (P = .004) and ORTHOCORD (P = .002) had significantly less cyclic elongation from cycle I to cycle II testing compared with the other sutures. ETHIBOND had the lowest peak load at failure (P = .002). FiberWire had the greatest stiffness (P = .006).

Conclusions

Compared with other suture types, the self-tensioning suture showed dynamic properties, demonstrating a decrease in loop length when soaked in a saline bath. This length was maintained after a second soak despite increased loop length during interval cyclic loading.

Clinical Relevance

Knot and loop security are of paramount importance to arthroscopic soft-tissue procedures. The ability for a suture to self-tension has implications for how it may interact with tissues in vivo to increase construct stability after arthroscopic soft tissue repair procedures.

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来源期刊
CiteScore
2.70
自引率
0.00%
发文量
218
审稿时长
45 weeks
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