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Shear Lag Sutures: Improved Suture Repair Through the Use of Adhesives

[+] Author Affiliations
Stephen W. Linderman, Ioannis Kormpakis, Richard H. Gelberman, Guy M. Genin

Washington University in St. Louis, St. Louis, MO

Victor Birman

Missouri University of Science & Technology, St. Louis, MO

Ulrike G. K. Wegst

Dartmouth College, Hanover, NH

Stavros Thomopoulos

Columbia University, New York, NY

Paper No. IMECE2016-67522, pp. V003T04A077; 9 pages
doi:10.1115/IMECE2016-67522
From:
  • ASME 2016 International Mechanical Engineering Congress and Exposition
  • Volume 3: Biomedical and Biotechnology Engineering
  • Phoenix, Arizona, USA, November 11–17, 2016
  • Conference Sponsors: ASME
  • ISBN: 978-0-7918-5053-4
  • Copyright © 2016 by ASME

abstract

Conventional surgical suture is mechanically limited by the ability of the suture to transfer load to tissue at suture anchor points. Sutures coated with adhesives can improve mechanical load transfer beyond the range of performance of existing suture methods, thereby strengthening orthopaedic repairs and decreasing the risk of failure. The mechanical properties of suitable adhesives were identified using a shear lag model. Examination of the design space for an optimal adhesive demonstrated requirements for strong adhesion and low stiffness to maximize strength. As a proof of concept, cyanoacrylate-coated sutures were used to perform a clinically relevant flexor digitorum profundus tendon repair in cadaver tissue. Even with this non-ideal adhesive, the maximum load resisted by repaired cadaveric canine flexor tendon increased by ∼ 17.0% compared to standard repairs without adhesive. To rapidly assess adhesive binding to tendon, we additionally developed a lap shear test method using bovine deep digital flexor tendons as the adherends. Further study is needed to develop a strongly adherent, compliant adhesive within the optimal design space described by the model.

Copyright © 2016 by ASME

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