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Biomedical subjects

C Jurecka

Publications and source records attributed to C Jurecka.

2 recordsLinked to original sources

[Biodegradable meniscus fixations: a comparative biomechanical study].

PURPOSE: Numerous new all inside meniscus repair techniques using biodegradable fixation devices have become available in the last years. Few studies have dealt with the biomechanical properties of these implants so far. The aim of this study was to analyze meniscus repairs under cyclic loading conditions for different fixation devices (Meniscus Arrow, Clearfix Meniscal Screw, Meniscal Dart, BioStinger) and to compare them to standard suture techniques. MATERIAL AND METHODS: Eighty meniscus repairs on 27 medial porcine menisci were performed. For biomechanical testing loosening, number of failures, failure modes and failure loads were evaluated under cyclic and maximum loading conditions. Testing was performed on a materials testing machine. RESULTS: During cyclic loading 10 out of 40 (25%) fixation devices failed. A gap appeared between the 2 parts of the meniscus within the first loading cycles. The failure strengths obtained with the 4 meniscus fixation devices did not differ significantly (Meniscus Arrow: 44 N; Clearfix Meniscal Screw: 35 N; Meniscal Dart: 33 N; BioStinger: 54 N). Besides for the BioStinger, the values of the sutures were significantly higher. The use of a stronger suture material (PDS 0) increased the failure load significantly. During maximum loading the fixation devices failed by both pull-out of the head or the tip of the device, except for the BioStinger showing only pull-out of the head. All sutures failed by breakage, except for the PDS 0 horizontal sutures in which 50% of complete tissue failures could be noted. CONCLUSION: This study shows that meniscal fixation devices may fail under repetitive loading conditions. A gap appeared between the meniscal margins within the first loading cycles irrespective of the suture type and fixation device used. Both gapping and failure modes of the fixation devices may be design-specific. The maximum failure loads differed significantly between the bioabsorbable devices and the sutures. Stronger suture materials increased the failure loads significantly. To allow a complete evaluation of new meniscus fixation devices not only biomechanical, but also biological and clinical parameters need to be analyzed in forthcoming studies.

Absorbable Implants↗

[Effect of various suture strength factors on behavior of meniscus sutures in cyclic loading conditions].

The aim of this study was to analyze meniscal sutures under cyclic loading conditions for different suture types (vertical and horizontal mattress sutures) and suture materials (absorbable monofilament sutures: PDS 2-0; PDS-0, and PDS-1 USP). Testing was performed on medial porcine menisci, using a well-established biomechanical testing model with a complete longitudinal tear 3 mm from the periphery of the meniscus. Sixty specimens were used. One suture was tested at a time. During cyclic testing 100 load cycles were applied with a crosshead speed of 50 mm/min. Three different maximum loads (10 N, 20 N, and 40 N) were used. The preload was set at 5 N. After cyclic loading, the specimens were loaded until failure. During cyclic loading, a gap appeared between the two parts of the meniscus, and partial tissue failures were observed at the surface of the meniscus. Gapping was more marked with higher loads and with the weaker suture material (p < 0.001). Using PDS 0 and PDS 1 sutures, less partial tissue failures were observed compared to PDS 2-0 (p < 0.001). The ultimate failure loads after cyclic loading were higher with PDS-0 and PDS-1 sutures. With these suture materials vertical sutures were stronger than horizontal sutures (p < 0.05). Using PDS 2-0 this difference could not be found. These results show that the primary strength of meniscal sutures depends on the suture material. The frequency and the amount of gapping and partial tissue failures, which can be observed under cyclic loading, are less distinct with PDS-0 and PDS-1 compared to PDS 2-0. From a biomechanical point of view, PDS 0 and PDS 1 sutures are recommended for meniscal sutures to guarantee a high primary stability, a small amount of gapping, and few partial tissue failures.

Animals↗