Monofilament Nylon Leader Research Articles

Ex vivo biomechanical evaluation of extracapsular stabilization with quasi-isometric points in canine cranial cruciate ligament-deficient stifles.

Cranial cruciate ligament (CCL) disease is one of the most common causes of lameness in dogs. The extracapsular stabilization (ECS) utilizing bone anchors and monofilament nylon leader was an alternative treatment for CCL-deficient (CCLD) dogs. However, the biomechanical response of the canine stifle to such a surgical repair strategy in conjunction with the use of recently reported quasi-isometric anchoring points remains unclear. The objectives of the study were to evaluate the mobility and stability of CCL-intact, CCLD, and CCLD stifles repaired with ECS at two different pairs of quasi-isometric points (quasi-IPs). Twelve stifle specimens from 7 dogs underwent mobility and stability tests under 4 different conditions, namely, CCL-intact, CCLD, and ECS-repaired at 2 different pairs of quasi-IPs (referred to as ECS-IP1 and ECS-IP2). The mobility tests evaluated 6 degrees-of-freedom stifle kinematics during flexion and extension. The stability tests involved cranial drawer and tibial internal rotation (IR) tests at various stifle opening angles and quantifying the cranial tibial translation (CTT) and tibial IR angles under constantly applied loadings. The ECS repaired at quasi-IPs was shown to restore cranial instability of the stifles with averaged CTT magnitudes < 1.4mm. During the tibial IR test, the ECS treatments resulted in significantly less tibial IR compared to those in intact CCL stifles. The mobility tests showed similar results. The 2 chosen pairs of quasi-IPs were shown to effectively correct the excessive CTT caused by CCLD stifles, whereas the excessive tibial external rotation in comparison to those of intact stifles should be considered for its subsequent influence on joint alignment and the contact pressure applied to the stifle joint.

Crimped monofilament nylon leader for median sternotomy closure in 10 dogs.

To describe and report the outcomes after closure of median sternotomies with crimped monofilament nylon leader (MNL) in dogs. Retrospective observational study. Dogs (n = 10) that underwent intrathoracic surgery through a median sternotomy approach. The median sternotomy was closed in a peristernal figure eight pattern with crimped MNL. Medical records were reviewed for clinical and histopathological findings and complications. Owners or veterinarians were contacted to collect long-term follow-up information. The technique was simple, with no intraoperative complications. Postoperative infection was documented in one dog, requiring removal of a single MNL and associated crimp clamp. Delayed healing of the surgical incision in one dog was managed conservatively. No other complications were documented throughout long-term follow-up at a median of 488 days (range, 199-608). Median sternotomies were successfully closed with crimped MNL and were associated with a low complication rate. Crimped MNL represents an alternative method to close median sternotomies in dogs.

Incomplete pentalogy of Cantrell in a Border terrier puppy

A 4-month-old, 6.4-kg, male entire, Border terrier was referred for investigation of exercise intolerance and a suspected congenital midline defect. Physical examination revealed a sternal and a supraumbilical abdominal defect....

Mini-Invasive Extraarticular Stabilization of the Cranial Cruciate Deficient Stifle in Dogs

The purpose of this work was to describe three mini-invasive techniques for extraarticular stabilization of the deficient stifle based of bone anchores inserted in quasi-isometric sites.Suture stabilization of the stifle consisted of placing a monofilament nylon leader line or polyethylene suture between femoral site adjacent to the distal poles of the fabella, and tibial site immediately cranial to the long digital extensor tendon, using two anchor types. Each stifle was tested (cranial drawer test and tibial compression test) before and after arthroscopic transection of the cranial cruciate ligament and after performing the assigned procedure. Surgical approach, order of procedural steps, drill hole entrance and exit points, and techniques for anchors placement, tensioning, and securing were described.The results of the cranial drawer test and tibial compression test do not show statistically significant differences between the three applied techniques. All three techniques provide passive stability to the deficient stifle.

Retrospective Study Comparing Two Materials Commonly Used in the LFS Technique for CCLR

Cranial cruciate ligament rupture (CCLR) is the most common cause of degenerative joint disease (DJD) in the stifle of adult dogs. Over the last several years, a new generation of nonabsorbable, multifilament, polyblend polyethylene orthopedic suture materials have been evaluated for use in the lateral fabellar suture (LFS) technique for surgical treatment of CCLR. This retrospective study compared the short-term outcome of 16 dogs that were treated using the LFS technique using either a proprietary polyblend polyethylene orthopedic suture material (FW) or monofilament nylon leader line (NLL). The FW was significantly more likely to fail compared with the NLL (P = 0.0379). Specifically, the FW was 14.667 times likelier to fail than the NLL. When one and two strands of NLL were compared with FW, the FW was 6 times more likely to fail than one strand of NLL and 32 times more likely to fail than two strands of NLL. To the authors' knowledge, this is the first study comparing the two materials used in the LFS procedure performed in clinical cases.

Mechanical testing of orthopaedic suture material and a crimp clamp system for the extracapsular stabilisation of canine cruciate-deficient stifles

The cranial cruciate ligament (CCL) provides cranio-caudal stability, prevents hyperextension and constrains medial rotation of the tibia in the canine stifle joint and CCL rupture is the leading cause of hind leg lameness in dogs. Treatment of CCL rupture aims to resolve lameness caused by joint instability and provide good long-term function of the affected hind limb. The extracapsular technique is one of the most popular methods to restore joint stability. The technique involves a suture loop that is placed around the lateral fabella and through the tibial tuberosity. The ideal suture material should be strong, aseptic, easily handled, inexpensive, and provide excellent knot security and knot compactness. A critical property of the loop is the application of either a knot or crimp to maintain the tension on the loop. There is a variety of orthopaedic suture materials used for the extracapsular technique. Our aim was to compare the mechanical properties of four commercially available materials in pure tension. The materials tested were monofilament nylon leader (MNL) 100 lb, MNL 80 lb, Supramid and Silon. Our second objective was to compare the interoperator variability of applying either a knot or a crimp to secure the suture loop. Ultimate tensile strength was greatest with MNL 100 lb (373 N) followed by MNL 80 lb (285 N), Supramid (160 N) and Silon (103 N). Based on our results, we conclude that MNL 100 lb and MNL 80&amp;nbsp;lb are mechanically superior to Silon and Supramid. Our study also shows significant effects for the operator and method of loop fixation (P &amp;lt; 0.0001). Intraoperator differences were also found to be significant, for operator 1 (P &amp;lt; 0.0001), for operator 2 (P &amp;lt; 0.001) and operator 3 (P &amp;lt; 0.01). Our findings indicate that MNL is most suitable orthopaedic material and that loop fixation should remain the method of choice for surgeons treating CCL.

In vitro mechanical evaluation and comparison of two crimping devices for securing monofilament nylon and multifilament polyethylene for use in extracapsular stabilization of the canine stifle

To compare the tensile strength and stiffness of non-absorbable suture loops created with two types of crimping devices. Loops of monofilament nylon leader line (MN) of 18 kg, 36 kg, and 45 kg multifilament polyethylene (MP) with a crimp and MP with a crimp and knot were mechanically tested to failure in quasistatic tensile loading after being created with either a wave pattern crimp device or three applications of a single crimp device. Each testing group consisted of five samples. Tensile loading to failure at a rate of 9.5 mm/s was used. Failure was defined as a sudden drop in the recorded force. All suture materials failed by breaking near the crimp tube with both crimp devices, with exception of the MP without knot, which slipped through the crimp tube using both devices. Sutures secured with the wave pattern crimping device were significantly stronger with a higher load yield, maximum load, displacement yield, failure displacement, and maximum displacement than the single crimp device. Loops of MP suture crimped by either device plus the addition of a surgeon's knot resulted in a significantly stronger construct than unknotted crimped MP constructs. Crimped MP combined with knot were significantly stiffer, but not stronger, than crimped 45 kg MN. Performing extra- capsular repair for ruptured cranial cruciate ligaments with the wave pattern crimp system may result in lower failure rates due to the construct being significantly stronger than the single crimp system.

Mechanical Testing of Orthopedic Suture Material Used for Extra‐Articular Stabilization of Canine Cruciate Ligament‐Deficient Stifles

To determine (1) if braided, polyblend orthopedic suture materials are mechanically superior to monofilament nylon leader and (2) have mechanical properties similar to biomechanical properties of the canine cruciate ligament. Different suture material types. Mechanical testing was performed on 5 different orthopedic suture materials: 80# test Mason monofilament nylon leader (MNL), FiberTape (FT), FiberWire (FW), Xgen OrthoFiber (XOF), and LigaFiba (LF) using a servohydraulic materials-testing machine. Materials were loaded to failure while collecting data for tensile strength, load at 3 mm and 5 mm of elongation and stiffness. Cyclic elongation of each suture material was tested under physiologic loading between 70 and 150 N for 1000 cycles using 3 mm of elongation to describe excessive elongation. Load at 3 mm of elongation and performance during cyclic testing were compared to previously published physiologic loads in the dog stifle. Ultimate tensile strength was greatest with LF, followed by XOF that was stronger than FT and FW, and the weakest was MNL. LF was the stiffest of all tested materials at 3 mm of elongation. Cyclic elongation was greatest for the MNL elongating 3.75 mm after 1000 cycles. All polyblend braided materials continued to elongate throughout the 1000 cycles under physiologic loads. Polyblend suture materials are stronger and elongate less than MNL in pure tension. The mechanical performance of all sutures tested is questionable when compared with the mechanical demands of the normal stifle in a mid-sized dog.

Mechanical comparison of six loop fixation methods with monofilament nylon leader line

SummaryMonofilament nylon leader line (MNL) is a popular prosthetic material used by veterinary surgeons for extra-capsular cranial cruciate ligament repair. Careful examination of MNL fixation methods has been reported, but a comprehensive comparison has not been done. This study evaluated three unpublished novel methods of MNL loop fixation [Harris wire tightener (knotter), Securos® crimp clamp system, self-locking knot] to traditional methods of MNL loop fixation (clamped square knot, sliding half hitch knot). Loops (27.3 kgt and 36.4 kgt) were distracted at 500 mm/min until failure by breaking or slipping. Ultimate force, elongation and stiffness were used for comparison of loop fixation methods. All of the loops failed by breaking within 3.0 mm of knot or clamp. The Harris knotter had significantly greater elongation than all other loops, except for the self-locking knot. The self-locking knot required the most force to failure; however, it was not superior if the doublestranded configuration was considered. If the mechanical properties of the knot method is considered in light of the subjective handling characteristics, the Securos® crimp clamp system had equivalent strength measurement for the 27.3 kgt MNL loops and was stronger than traditional methods using the 36.4 kgt MNL. The Securos® system recommends use of the larger diameter MNL and it allows a surgeon to overcome potential difficult handling characteristics previously encountered with knot formation and security.

Comparison of Fishing Line for Repair of the Cruciate Deficient Stifle

SummaryNumerous types of suture material have been used for extra-articular cranial cruciate ligament stabilization. Although monofilament nylon leader line is considered by some to be the most appropriate material for this procedure, monofilament nylon fishing line is a popular alternative (8, 13). The purpose of this study was to evaluate four brands of nylon fishing line in order to determine the superiority of the material as well as the sterilization method of choice. The four brands of monofilament fishing line tested were 36 kilogram test “Ande”, “Berkley”, “Hi-Seas”, and “Maxima”.“Ande” and “Maxima” proved superior in strength prior to sterilization. When the materials were sterilized by ethylene oxide, minimal elongation was observed. However, there was a significant decrease in strength for three of the four materials (“Ande”, “Hi-Seas”, and “Maxima”) when compared to unsterilized or to steam sterilized samples. Steam sterilization resulted in significant elongation of all materials tested and had a variable effect on strength (either greater, equal, or less than no sterilization). Considering all materials, “Ande” was the nylon material of choice when ethylene oxide was used for sterilization, and “Ande” or “Maxima” were the nylon materials of choice when steam sterilization was used.The strength and elongation of four brands of thirty-six-kilogram test monofilament nylon fishing line were tested using a materials testing machine without sterilization and following either steam or ethylene oxide sterilization. “Ande” was the nylon material of choice when ethylene oxide was used for sterilization and “Ande” or “Maxima” were the nylon materials of choice when steam sterilization was used.

Biomechanical evaluation of a crimp clamp system for loop fixation of monofilament nylon leader material used for stabilization of the canine stifle joint.

To test a crimp clamp system designed to secure monofilament nylon leader (MNL) material commonly used as lateral fabellotibial sutures (LFS) in extra-articular stabilization of the canine stifle joint. In vitro biomechanical tests of MNL loops secured with either the crimp clamp system or knots were performed. Suture loops (n = 94) were created from 27.3 kg tensile strength MNL and fastened with knots or crimp clamps. Tests were conducted on steam-sterilized, ethylene-oxide-sterilized, and nonsterilized MNL sutures. Loops were evaluated in single load tests and cycled tests. Values for load to failure, initial loop tension, loop elongation, mode of failure, and point of failure were determined. Crimp-clamped loops were superior to knotted loops in all parameters tested in both cycled and noncycled tests. Loop failure generally occurred by breaking within 3 mm of the fixation in both clamped and knotted tests. Loop elongation after cycling was greater in the knotted loops compared with clamped loops (P < .001). Load to failure was greater in clamped tests than in knotted tests (P < .001), regardless of sterilization technique used. Significantly higher initial loop tension could be achieved with the clamp system compared with knot fixation (P < .001). The crimp clamp system provides superior in vitro loop fixation characteristics compared with knot fixation in 27.3 kg test MNL. Based on the results of biomechanical testing and the known biocompatibility of the system's implant components, clinical trials using the crimp clamp system are warranted.

Biomechanical Evaluation of the Suitability of Monofilament Nylon Fishing and Leader Line for Extra-articular Stabilisation of the Canine Cruciate-deficient Stifle

SummaryThe use of monofilament nylon line for extra-articular stabilisation of the cruciate deficient canine stifle is widespread in veterinary surgery. The purpose of this study was twofold: 1) to examine the mechanical behaviour of two forms of monofilament line - standard nylon fishing line (NFL) and nylon leader line (NLL) - when sterilised by steam or ethylene oxide and formed into loops approximating their use in the clinical situation; 2) to compare the mechanical performance of the canine fabellar attachment site to the steel hooks used in the first part of the study.It was found that NLL loops were not affected by sterilisation and had higher failure loads and stiffness than NFL loops. Further testing of 27-kilo - gram-test (kgt) and 36 kgt steam-sterilised NFL and NLL found that of the materials tested, NLL 27 kgt was most suitable as an extra-articular stabiliser of the canine stifle. The performance of the fabellar attachment site was superior to the steel hooks when cycled to 50 N and inferior when cycled to 100 N.The suitability of monofilament nylon fishing line (NFL) and monofilament nylon leader line (NLL) for use as lateral fabel-lotibial sutures (LFTS) in canine cranial cruciate ligament repair was investigated. In vitro testing of loops of the materials was performed with steel hook and fabellar attachment points. Twenty-seven-kilogram test NLL was found to be the most suitable nylon line from which to construct an LFTS.