Mechanical analysis of suture attachment methods in toggle suture constructs

Abstract

Objective To determine the effect of the method used to attach OrthoFiber #5 to a 1/8‐in Securos toggle rod on the mechanical properties of the resulting construct. Study design Prospective bench top mechanical analysis. Sample population One hundred twenty‐eight OrthoFiber #5‐toggle rod suture constructs. Methods Toggle–suture constructs (groups A‐H) were prepared by using 8 methods to attach OrthoFiber #5 to a 1/8‐in toggle rod (n = 16 constructs/group). A servohydraulic materials‐testing machine was used to test each toggle–suture construct in tension. Mean load to failure, cycles to failure, construct stiffness, and suture elongation under static and cyclic loading were compared among types of constructs. Results Mean load to failure was greatest (>500 N) for constructs D (P ≤ .048) and G (P ≤ .048). Mean construct stiffness of D (53.52 N/mm) and E (53.6 N/mm) was greater than that of the 6 other constructs (P ≤ .040). Construct A sustained the most elongation in acute (23.47 mm; P < .001) and cyclic (18.53 mm; P < .003) loading. Cycles to failure was greater for construct C (622 cycles) compared with constructs A, B, and H (P = .008, P = .009, and P = .010, respectively). Conclusion The method used to attach OrthoFiber #5 to a 1/8‐in toggle rod influenced the mechanical properties of the construct. No one construct outperformed other groups in all areas of testing, but construct D was superior when mean load to failure and construct stiffness were considered. Clinical impact Construct D, with OrthoFiber #5, passed straight through the toggle rod eyelet, may provide superior stability and resistance to fatigue failure to toggle‐in repairs of coxofemoral luxations.

Complications and outcomes of cats with coxofemoral luxation treated with hip toggle stabilization using ultrahigh–molecular‐weight‐polyethylene or nylon (2009‐2018): 48 cats

“…Mechanical characteristics of different sutures used in HTS constructs and methods of suture attachment to the toggle have been evaluated by several investigators 29‐32 . Braided ultrahigh– molecular‐weight‐polyethylene (UHMWPE) has been demonstrated to be mechanically superior to monofilament nylon leader because of its higher tensile strength, increased stiffness, and greater resistance to elongation 30‐32 .…”

Arthroscopic-Assisted Toggle Rod Stabilization in Canine Coxofemoral Luxation: A Cadaveric Study

“…In canine cadaveric studies, braided high tensile strength sutures, as used in this study, have shown superior in vitro mechanical properties with better mechanical predictability over monofilament sutures. [20][21][22][23][24][25][26] In clinical cases, one would expect this to translate into less suture breakage and a lower luxation rate when multifilament suture is chosen over monofilament. The reported reluxation rate with TightRope is 5.8%, lower than the 11 to 25% rate previously reported with monofilament repairs.…”