Arthroscopic suture retrievers and shuttles: a biomechanical investigation of the force required for tendon penetration and defect size

BMC Musculoskeletal Disorders

Dominik C. Meyer¹  Georg Lajtai²  Karl Wieser¹  Christopher G. Lenz¹ 

[1]Orthopaedic Department, Balgrist Hospital, University of Zurich, Forchstrasse 340, Zurich, CH-8008, Switzerland

[2]Orthopaedic Department, Private Hospital Maria Hilf, Klagenfurt, Austria

关键词: Iatrogenic damage;    Lesion size;    Suture shuttle;    Suture retriever;    Tendon;    Rotator cuff;   

Others  :  1233988
DOI  :  10.1186/s12891-015-0794-9

 received in 2014-12-10, accepted in 2015-10-29,  发布年份 2015

【 摘 要 】

Background

To compare instruments designed for arthroscopic suture handling during arthroscopic rotator cuff repair, to assess the force needed to penetrate the tendon, and to evaluate the residual defect size.

Methods

Twenty-one instruments were each tested ten times on thawed sheep infraspinatus tendons. The force needed to pierce the tendon with each instrument was measured using a custom setup. Bone wax plates were used to make the perforation marks visible and to quantify the lesions each instrument created.

Results

The force to pierce a tendon had a range of 5.6–18.5 N/mm. Within the group of suture retrievers, the angled instruments required in average 85 % higher forces than straight instruments. The lesion area had a range of 2–7 mm ² . Suture retrievers produced significantly larger lesion sizes compared with suture shuttles.

Conclusion

For the identical task of passing a suture through a tendon, differences exist regarding the ease of tendon penetration and potential damage to the tendon for different tools. The design, function, and resulting lesion size may be relevant and important for surgical handling and to avoid excess structural damage to the tendon. These results suggest that choosing the most appropriate tools for arthroscopic suture stitching influences the ease of handling and final integrity of the tissue.

Level of evidence

Mechanical evaluation of surgical devices.

【 授权许可】

   
2015 Lenz et al.

【 图 表 】

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