Tensions generated in a lateral fabellotibial suture model. Comparison of methods of application of tension, fixation of tension and suture material.

Abstract

To compare suture tension on a simulated lateral fabellotibial suture model using various methods of application of tension, fixation, and suture materials. Veterinarians constructed simulated lateral fabellotibial suture constructs on a tying stand with a force sensor. Participants used combinations of 45 kg test monofilament nylon, metric 7 braided polyethylene, crimps, crimper, or knots, with their choice of instruments to secure the constructs. The tension in completed constructs was measured and comparisons were made between nylon and polyethylene, the use of crimps compared to knots, and the use of a mechanical distractor compared to hand tightening techniques. A value of p <0.05 was considered significant. Fifty-eight veterinarians created 72 lateral suture constructs. Final tensions generated ranged from 1.4-171.0N. The median tension of nylon sutures (43.9N ± 44.7N) was significantly greater than polyethylene sutures (9.5 N ± 19.6N). The median tension of constructs secured with crimps (62.8N ± 42.4N) was significantly greater than constructs secured with knots (11.8 N ± 14.8N). The mechanical distractor generated significantly higher median tension (78N ± 50.4N), compared to methods without the device (18.6 N ± 25.1N). There was a large variability in the tension generated in simulated lateral fabellotibial constructs. Veterinarians who used nylon, crimps, and the mechanical tensioner generated constructs with greater tensions.