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Biomechanical cadaveric comparison of patellar ligament suture protected by a steel cable versus a synthetic cable

BACKGROUND: Purpose and hypothesis: Patellar ligament rupture is a rare disabling pathology requiring a surgical ligament suture protected by a frame. The gold standard is the steel cable, but its rigidity and the necessity of a surgical re-intervention for its removal render it unsatisfactory. The...

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Autores principales: Bouget, P., Breque, C., Beranger, J. S., Faure, J. P., Khiami, F., Vendeuvre, T.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5362567/
https://www.ncbi.nlm.nih.gov/pubmed/28332149
http://dx.doi.org/10.1186/s40634-017-0084-6
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author Bouget, P.
Breque, C.
Beranger, J. S.
Faure, J. P.
Khiami, F.
Vendeuvre, T.
author_facet Bouget, P.
Breque, C.
Beranger, J. S.
Faure, J. P.
Khiami, F.
Vendeuvre, T.
author_sort Bouget, P.
collection PubMed
description BACKGROUND: Purpose and hypothesis: Patellar ligament rupture is a rare disabling pathology requiring a surgical ligament suture protected by a frame. The gold standard is the steel cable, but its rigidity and the necessity of a surgical re-intervention for its removal render it unsatisfactory. The objective of this paper is to quantify the mechanical protection provided by the terylene® in comparison with steel. METHODS: Twenty-four knees of 12 fresh frozen cadaveric subjects were divided into 2 homogeneous groups (terylene and steel) of 12 knees (mean age = 69.3 years). Proximal ligament repair was performed according to a three-tunnel transosseous reinsertion technique. Mechanical tests were performed in flexion to simulate movement of the knee. The interligament gap and the amplitude angulation of the knee were measured by a system of extensometer and optical goniometer. Mechanical analysis permitted calculation of flexion amplitude for a ligament gap of 1 and 2 mm taking as initial angle the adjusting angle of pretension of the protection frame. Study of deformations of frames was performed. Statistical analysis was performed with a Wilcoxon Mann Whitney test. RESULTS: There is no significant difference in protection of the ligament suture between the “terylene” and “steel” groups. Mean flexion amplitudes (mΔF) show no significant differences between the 2 groups for a distension of the suture of 1 mm (m ΔF terylene1 = 4.74 °; mΔF steel1 = 5.91°; p = 0.198) and 2 mm (mΔF terylene2 = 8.71°; mΔF steel2 = 10.41°; p = 0.114). Elastic deformation of terylene was significantly greater than that of steel (p = 0.0004). CONCLUSION: Suture protection of the patellar ligament by a terylene wire is not significantly different from that provided by steel frame. The elastic properties of terylene and absence of a need for re intervention to secure its removal lead us towards its use in acute ruptures of the patellar ligament. The main limits involve the properties of the chain extenders with no contraction/muscle shortening and partial dehydration of tendons and ligaments and the mean age of 69.3 years. Level 5. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s40634-017-0084-6) contains supplementary material, which is available to authorized users.
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spelling pubmed-53625672017-04-06 Biomechanical cadaveric comparison of patellar ligament suture protected by a steel cable versus a synthetic cable Bouget, P. Breque, C. Beranger, J. S. Faure, J. P. Khiami, F. Vendeuvre, T. J Exp Orthop Research BACKGROUND: Purpose and hypothesis: Patellar ligament rupture is a rare disabling pathology requiring a surgical ligament suture protected by a frame. The gold standard is the steel cable, but its rigidity and the necessity of a surgical re-intervention for its removal render it unsatisfactory. The objective of this paper is to quantify the mechanical protection provided by the terylene® in comparison with steel. METHODS: Twenty-four knees of 12 fresh frozen cadaveric subjects were divided into 2 homogeneous groups (terylene and steel) of 12 knees (mean age = 69.3 years). Proximal ligament repair was performed according to a three-tunnel transosseous reinsertion technique. Mechanical tests were performed in flexion to simulate movement of the knee. The interligament gap and the amplitude angulation of the knee were measured by a system of extensometer and optical goniometer. Mechanical analysis permitted calculation of flexion amplitude for a ligament gap of 1 and 2 mm taking as initial angle the adjusting angle of pretension of the protection frame. Study of deformations of frames was performed. Statistical analysis was performed with a Wilcoxon Mann Whitney test. RESULTS: There is no significant difference in protection of the ligament suture between the “terylene” and “steel” groups. Mean flexion amplitudes (mΔF) show no significant differences between the 2 groups for a distension of the suture of 1 mm (m ΔF terylene1 = 4.74 °; mΔF steel1 = 5.91°; p = 0.198) and 2 mm (mΔF terylene2 = 8.71°; mΔF steel2 = 10.41°; p = 0.114). Elastic deformation of terylene was significantly greater than that of steel (p = 0.0004). CONCLUSION: Suture protection of the patellar ligament by a terylene wire is not significantly different from that provided by steel frame. The elastic properties of terylene and absence of a need for re intervention to secure its removal lead us towards its use in acute ruptures of the patellar ligament. The main limits involve the properties of the chain extenders with no contraction/muscle shortening and partial dehydration of tendons and ligaments and the mean age of 69.3 years. Level 5. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s40634-017-0084-6) contains supplementary material, which is available to authorized users. Springer Berlin Heidelberg 2017-03-23 /pmc/articles/PMC5362567/ /pubmed/28332149 http://dx.doi.org/10.1186/s40634-017-0084-6 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Research
Bouget, P.
Breque, C.
Beranger, J. S.
Faure, J. P.
Khiami, F.
Vendeuvre, T.
Biomechanical cadaveric comparison of patellar ligament suture protected by a steel cable versus a synthetic cable
title Biomechanical cadaveric comparison of patellar ligament suture protected by a steel cable versus a synthetic cable
title_full Biomechanical cadaveric comparison of patellar ligament suture protected by a steel cable versus a synthetic cable
title_fullStr Biomechanical cadaveric comparison of patellar ligament suture protected by a steel cable versus a synthetic cable
title_full_unstemmed Biomechanical cadaveric comparison of patellar ligament suture protected by a steel cable versus a synthetic cable
title_short Biomechanical cadaveric comparison of patellar ligament suture protected by a steel cable versus a synthetic cable
title_sort biomechanical cadaveric comparison of patellar ligament suture protected by a steel cable versus a synthetic cable
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5362567/
https://www.ncbi.nlm.nih.gov/pubmed/28332149
http://dx.doi.org/10.1186/s40634-017-0084-6
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