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Arthroscopy. 2016 Jun;32(6):1010-6. doi: 10.1016/j.arthro.2015.12.044. Epub 2016 Mar 2.

Biomechanical Performance of Hip Labral Repair Techniques.

Author information

1
Department of Orthopedic Surgery, Dokuz Eylül University, İzmir, Turkey. Electronic address: onurhapa@gmail.com.
2
Plano Orthopedic & Sports Medicine Center, Plano, Texas, U.S.A.
3
Department of Orthopedic Surgery, Dokuz Eylül University, İzmir, Turkey.
4
Department of Biomechanics, Dokuz Eylül University, İzmir, Turkey.

Abstract

PURPOSE:

To determine the strength of various suture techniques and the impact of suture passer size on cyclically loaded hip labra.

METHODS:

We assigned 63 bovine hip labra to 9 simple knotless suture technique groups using OrthoCord suture: (1) penetrating grasper (2.6 mm)-placed horizontal mattress, (2) penetrating grasper-placed vertical mattress, (3) SutureLasso (1.8 mm)-placed vertical mattress, (4) penetrating grasper-placed oblique repair, (5) penetrating grasper-placed vertical mattress plus radiofrequency, (6) SutureLasso-placed horizontal mattress, (7) SutureLasso-placed oblique mattress, (8) SutureLasso-placed horizontal mattress plus radiofrequency, and (9) SutureLasso-placed oblique mattress plus radiofrequency. After 20 cycles of uniaxial tensile loading (5 to 80 N), destructive testing was performed.

RESULTS:

Penetrating grasper-placed horizontal mattress sutures showed lower ultimate failure loads than vertical and oblique mattress sutures (P < .05). Penetrating grasper-placed vertical mattress sutures had higher peak-to-peak displacement than SutureLasso-placed vertical mattress sutures (P = .04). SutureLasso-placed oblique mattress sutures had a higher ultimate load (P < .01) and stiffness (P = .04) than SutureLasso-placed horizontal mattress sutures. SutureLasso-placed horizontal mattress sutures had lower cyclic elongation than penetrating grasper-placed horizontal mattress sutures (P = .01) and lower ultimate load (P < .01) and stiffness than SutureLasso-placed vertical mattress sutures (P < .01). Horizontal mattress sutures with radiofrequency had a higher ultimate load (P = .02), stiffness, and cyclic elongation (P < .01) than without radiofrequency.

CONCLUSIONS:

A horizontal mattress hip labrum stitch shows a lower ultimate failure load than vertical or oblique mattress stitches. Smaller-diameter suture-passing devices show less cyclic displacement and elongation than larger-diameter devices. Radiofrequency labral treatment does not alter vertical stitch strength but does alter horizontal mattress stitch strength.

CLINICAL RELEVANCE:

Vertical and oblique stitches are stronger than horizontal stitches. A 1.8-mm passing device shows a better cyclic loading performance than a 2.6-mm device.

PMID:
26944668
DOI:
10.1016/j.arthro.2015.12.044
[Indexed for MEDLINE]

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