Mechanical Comparison of Suture Material and Knot Type Used for Fabello-Tibial Sutures

B. S. Nwadike; S. C. Roe

doi:10.1055/s-0038-1632608

Veterinary and Comparative Orthopaedics and Traumatology, Table of Contents

Vet Comp Orthop Traumatol 1998; 11(01): 47-52
DOI: 10.1055/s-0038-1632608

Original Research

Schattauer GmbH

Mechanical Comparison of Suture Material and Knot Type Used for Fabello-Tibial Sutures

Authors

B. S. Nwadike

¹From the College of Veterinary Medicine, North Carolina State University, Raleigh, USA
S. C. Roe

¹From the College of Veterinary Medicine, North Carolina State University, Raleigh, USA

Abstract

Summary

Many different suture materials have been used for extra-articular stabilization of the canine cruciate-deficient stifle. In this study, two different materials frequently used as fabello-tibial sutures (27-kilogram-test [kgt] nylon fishing line [labeled 60-pound-test] and 27-kgt nylon leader line) and two knot types used to tie these materials (square knot and slip knot) were evaluated mechanically in vitro. Twenty loops of each material were tied with each knot and evaluated. The purpose of the study reported herein was to compare the mechanical performance of two different monofilament nylon materials and two knot types when subjected to: 1) continuous elongation until failure, and 2) cycling 10 times to 100 N followed by elongation to failure testing methods. Nylon leader line tolerated higher failure loads and deformed less than nylon fishing line for both knot types. Nylon fishing line secured with a square knot recovered resting tension more completely following cycling than nylon fishing line secured with a slip knot. Nylon leader line secured with a slip knot recovered resting tension following cycling better than leader line with a square knot and both fishing line groups. When used as fabello-tibial sutures, it is suggested that 27-kgt nylon leader line be secured with a slip knot, and 27-kgt nylon fishing line be secured with a square knot to optimize the mechanical performance of the loop.

The influence of knot type on the in vitro mechanical performance of monofilament nylon fishing line and monofilament leader line used as fabello-tibial sutures was investigated. Testing of loops of the materials tied with either a slip knot or a square knot was performed on steel hook attachment points. When used as fabello-tibial sutures, it is suggested that 27-kgt nylon leader line be secured with a slip knot, and 27-kgt nylon fishing line be secured with a square knot to optimize the mechanical performance of the loop.

Keywords

Cranial cruciate ligament - monofilament nylon - material properties - knot - biomechanics

Full Text

References

REFERENCES
1 Korvick DL, Johnson AL, Schaeffer DJ. Surgeons’ preferences in treating cruciate ligament ruptures in dogs. J Am Vet Med Assoc 1994; 205: 1318-24.
2 Prostredny JM, Bauer MS, Blevins WE, Widmer WR, Davidson JR, Aiken SW, Toombs JP.. Effect of suture type on stifle biomechanics after extraarticular repair of cranial cruciate ligament transection in the dog. Vet Comp Orthop Traumatol 1991; 4: 144-9.
3 Beckman SL, Wadsworth PL, Henry WB. Technique for stabilizing the stifle with nylon bands in cases of ruptured anterior cruciate ligaments in dogs. J Am Anim Hosp Assoc 1992; 28: 539-44.
4 Patterson RH, Smith GK, Gregor TP, Newton CD. Biomechanical stability of four cranial cruciate repair techniques in the dog. Vet Surg 1991; 20: 85-90.
5 Trimbos JB. Security of various knots commonly used in surgical practice. Obstet Gynecol 1984; 64: 274-80.
6 Caporn TM, Roe SC. Biomechanical evaluation of the suitability of monofilament nylon fishing and leader line for extraarticular stabilisation of the canine cruciate deficient stifle. Vet Comp Orthop Traumatol 1996; 9: 126-33.
7 Rodheaver GT, Powell TA, Thacker JG, Edlich RF. Mechanical performance of monofilament synthetic absorbable sutures. Am J Surg 1987; 154: 544-7.
8 Dobrin PB. Surgical manipulation and the tensile strength of polypropylene sutures. Arch Surg 1989; 124: 665-8.
9 Rosin E, Robinson GM. Knot security of suture materials. Vet Surg 1989; 18: 269-73.
10 Fraunhofer JA, Storey RJ, Masterson BJ. Tensile properties of suture materials. Biomat 1988; 9: 324-7.
11 Rodheaver GT, Thacker JG, Edlich RF. Mechanical performance of polyglycolic acid and polyglactin 910 synthetic absorbable sutures. Surg Gynec Obstet 1981; 153: 835-41.
12 Tera H, Aberg C. Strength of knots in surgery in relation to type of knot, type of suture material and dimension of suture thread. Acta Chir Scand 1977; 143: 75-83.
13 Tera H, Aberg C. Tensile strength of 12 types of knots employed in surgery, using different suture materials. Acta Chir Scand 1976; 142: 1-7.
14 Hulse DA, Butler DL, Kay MD, Noyes FR, Shires PK, D’Ambrosia R, Shoji H.. Biomechanics of cranial cruciate ligament reconstruction in the dog I. In vitro laxity testing. Vet Surg 1983; 12: 109-12.
15 Butler DL, Hulse DA, Kay MD, Grood ES, Shires PK, D’Ambrosia R, Shoji H. Biomechanics of cranial cruciate ligament reconstruction in the dog II. Mechanical properties. Vet Surg 1983; 12: 113-8.
16 Budsberg SC, Vestraete MC, Soutas-Little RW, Flo GL, Probst CW. Force-plate analyses before and after stabilization of canine stifles for cruciate injury. Am J Vet Res 1988; 49: 1522-4.
17 Thacker JG, Rodheaver G, Moore JW. et al Mechanical performance of surgical sutures. Am J Surg 1975; 130: 374-80.
18 Dobrin PB. Polypropylene suture stresses following closure of longitudinal aretriotomy. J Vase Surg 1988; 7: 423-8.
19 Dobrin PB. Some mechanical properties of polypropylene sutures: Relationship to the use of polypropylene in vascular surgery. J Surg Res 1988; 45: 568-73.
20 Visser JD.. Dynamic strength of surgical suture materials. In Evaluation of Biomaterials.. Winter GD, Leray JL, deGroot K. eds. London: John Wiley & Sons Ltd; 1980. pp 269-74.
21 Coetzee GL. An in vitro comparison of two replacement techniques utilizing fascia lata after cranial cruciate ligament transection in the dog. Vet Comp Orthop Traumatol 1993; 6: 85-92.
22 Elliott DH. Structure and function of mammalian tendon. Biol Rev 1965; 40: 392-421.
23 Walker LB, Harris EH., Benedict JV.. Stressstrain relationship in human cadaveric plantaris tendon. A preliminary study. Med Elec Biol Eng 1964; 2: 31-8.
24 Grood ES, Noyes FR. Cruciate ligament prosthesis: strength, creep and fatigue properties. J Bone Joint Surg 1976; 58 A 1083-8.
25 Dupuis J, Harari J, Papageorges MC, Gallina AM, Ratzlaff M. Evaluation of fibular head transposition for repair of experimental cranial cruciate ligament injury in dogs. Vet Surg 1994; 23: 1-12.
26 Flo G. Modification of the lateral retinacular imbrication technique for stabilizing cruciate ligament injuries. J Am Anim Hosp Assoc 1975; 11: 570-6.
27 Arnoczky SP, Tarvin GB, Marshall JL. et al The over-the-top procedure: a technique for anterior cruciate ligament substitution in the dog. J Am Anim Hosp Assoc 1979; 15: 283-90.
28 Gambardella PC, Wallace LJ, Cassidy F. Lateral suture technique for management of anterior cruciate ligament rupture in dogs: a retrospective study. J Am Anim Hosp Assoc 1981; 17: 33-8.
29 Shires PK, Hulse DA, Liu W.. The underand- over fascial replacement technique for anterior cruciate ligament rupture in dogs: a retrospective study. J Am Anim Hosp Assoc 1984; 20: 69-77.
30 Smith GK, Torg JS. Fibular head transposition for repair of cruciate-deficient stifle in the dog. J Am Vet Med Assoc 1985; 187: 375-83.