Mechanical Evaluation of Two Loop Tensioning Methods for Crimp Clamp Extracapsular Stabilization of the Cranial Cruciate Ligament‐Deficient Canine Stifle

Abstract

The hand tightening method described is a valuable technique for unassisted surgeons without access to tensioning devices.

In Vitro Biomechanical Testing of the Tube Knot

“…The larger distribution of data points for the CC has been attributed to human error in grip strength when crimping, and could represent inconsistency in technique in live patients in inexperienced hands . Banwell et al reported static testing of nonmedical grade 40# nylon secured with Securos® CC with quite high variance (29%) in their results and slippage through the clamp compared to 60# and 80# nonmedical grade nylon constructs .…”

“…Lateral ECS transiently controls hyperextension, cranial drawer motion, and internal rotation of the tibia while periarticular fibrosis progresses . Mechanical properties of materials used for ECS including ultimate tensile strength, stiffness, and elongation have been compared in vitro . Ideally, ECS would be performed using a strong, relatively stiff material that has minimal elongation and a secure knotting method that is not bulky, yet is simple to perform with minimal instrumentation or assistance …”

“…Various knotting methods are commonly used for ECS procedures. The crimp clamp system (CC) and large diameter monofilament nylon leader line is a commonly performed technique for lateral ECS . Advantages of this method include simplicity and efficiency as well as a low‐profile knot within the periarticular tissues.…”

“…Additional crimp clamps are crimped onto each end of the nylon so the tensioning device can engage those, grip the nylon, and apply traction. Once the appropriate amount of tension is achieved, the center crimp clamp is compressed with the crimping device in three locations . The crimp generates friction on the leader line, increasing load and stiffness while decreasing elongation .…”

Mechanical Comparison of Loop and Crimp Configurations for Extracapsular Stabilization of the Cranial Cruciate Ligament‐Deficient Stifle

“…Jig construction was similar to previous studies. 21,30 Crimps were clamped using a compound-action crimper (Veterinary Instrumentation) as described by Moores et al 34 Briefly, partial clamping of the crimp was followed by progressive loop tightening before definitive clamping. Initial partial clamping was in the middle of the crimp and final clamping in 3 evenly spaced locations of the crimp and away from the end of the crimp.…”