[Influence of the suture technique and material on the mechanical behavior of a reinforced Mac Intosh graft].
The anterior cruciate ligament reconstruction by a biological graft augmented by a synthetic device allows theoretically to increase the strength of the composite graft during the remodeling period. The technical realization of the reinforcement is still controversial because it is difficult to obtain a mechanical compromise between a real effect of protection of the graft and a load sharing to favour the remodeling. When the graft and the augmentation device are tied together the ligature between them plays a fundamental mechanical role. The first goal of the present study was to define by calculation and experimentation the influence of the suturing method on the strength of the graft-device ligature. The second goal was to appreciate the possibility of using absorbable suture in such an application. Calculation allowed to show that the weakest area of the composite graft was the junction between the augmented and unaugmented parts of the graft. When increasing number and anchorage of sutures in this critical area it was possible to double the resistance of the ligature. To define the outcome of absorbable suture the strength decrease was measured during the resorption period. Two threads were tested: the polyglactin 910 (Vicryl) and the polydioxanon (PDS). The strength decrease was sudden and rapid for the Vicryl (50 p. cent in 3 weeks). For the PDS the strength loss was more gradual (50 p. cent in 8 weeks). With these two threads the strength duration appeared as incompetent to allow the augmentation to protect the graft during all the remodeling period.
Kerboull
L
L
Laboratoire de Recherches Orthopédiques, CNRS URA 1161 Faculté de Médecine Lariboisière-Saint Louis, Université Paris VII.
Christel
P
P
Meunier
A
A
D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D001696:Biomechanical Phenomena; D006801:Humans; D008875:Middle Aged; D016687:Polydioxanone; D011098:Polyglactin 910; D013536:Suture Techniques; D013537:Sutures; D013710:Tendons / Q000637:transplantation
D016687:Polydioxanone; D011098:Polyglactin 910
Influence de la technique et du matériel de suture sur le comportement mécanique du transplant de Mac Intosh renforcé.