de Wild, Michael
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- PublikationIncreased construct stiffness with meniscal repair sutures and devices increases the risk of cheese-wiring during biomechanical load-to-failure testing(SAGE, 15.06.2021) Müller, Sebastian; Schwenk, Tanja; de Wild, Michael; Dimitrou, Dimitris; Rosso, Claudio [in: Orthopaedic Journal of Sports Medicine]Background: Cheese-wiring, the suture that cuts through the meniscus, is a well-known issue in meniscal repair. So far, contributing factors are neither fully understood nor sufficiently studied. Hypothesis/purpose: To investigate whether the construct stiffness of repair sutures and devices correlates with suture cut-through (cheese-wiring) during load-to-failure testing. Study design: Controlled laboratory study. Methods: In 131 porcine menisci, longitudinal bucket-handle tears were repaired using either inside-out sutures (n = 66; No. 0 Ultrabraid, 2-0 Orthocord, 2-0 FiberWire, and 2-0 Ethibond) or all-inside devices (n = 65; FastFix360, Omnispan, and Meniscal Cinch). After cyclic loading, load-to-failure testing was performed. The mode of failure and construct stiffness were recorded. A receiver operating characteristic curve analysis was performed to define the optimal stiffness threshold for predicting meniscal repair failure by cheese-wiring. The 2-tailed t test and analysis of variance were used to test significance. Results: Loss of suture fixation was the most common mode of failure in all specimens (58%), except for the Omnispan, which failed most commonly because of anchor pull-through. The Omnispan demonstrated the highest construct stiffness (30.8 ± 3.5 N/mm), whereas the Meniscal Cinch (18.0 ± 8.8 N/mm) and Ethibond (19.4 ± 7.8 N/mm) demonstrated the lowest construct stiffness. The Omnispan showed significantly higher stiffness compared with the Meniscal Cinch (P < .001) and Ethibond (P = .02), whereas the stiffness of the Meniscal Cinch was significantly lower compared with that of the FiberWire (P = .01), Ultrabraid (P = .04), and FastFix360 (P = .03). While meniscal repair with a high construct stiffness more often failed by cheese-wiring, meniscal repair with a lower stiffness failed by loss of suture fixation, knot slippage, or anchor pull-through. Meniscal repair with a stiffness >26.5 N/mm had a 3.6 times higher risk of failure due to cheese-wiring during load-to-failure testing (95% CI, 1.4-8.2; P < .0001). Conclusion: Meniscal repair using inside-out sutures and all-inside devices with a higher construct stiffness (>26.5 N/mm) was more likely to fail through suture cut-through (cheese-wiring) than that with a lower stiffness (≤26.5 N/mm). Clinical relevance: This is the first study investigating the impact of construct stiffness on meniscal repair failure by suture cut-through (cheese-wiring).01A - Beitrag in wissenschaftlicher Zeitschrift
- PublikationThe new LassoLoop360° technique for biomechanically superior tissue grip(Springer, 2019) Müller, Sebastian; de Wild, Michael [in: Knee Surgery, Sports Traumatology, Arthroscopy]PurposeSuprapectoral tenodesis is a frequently used technique for treating pathologies of the long head of the biceps bra-chii (LHBB) tendon. However, so far, no Gold Standard treatment exist. Hence, the arthroscopic LassoLoop360 (LL360) technique is introduced aiming to provide secure fixation and improved biomechanical properties. It was hypothesized, that the LL360 technique would show superior biomechanical response to cyclic loading and ultimate load-to-failure testing compared to the commonly used simple Lasso Loop (SLL).MethodsTwenty-two porcine superficial flexor digitorum tendons were prepared using a No. 2 suture according to either the SLL or the LL360 technique. Displacement after cyclic loading (1.000 cycles) between 5 and 30 N, ultimate load-to-failure (ULTF), mode of failure as well as the construct stiffness were tested.ResultsSignificantly less displacement was found in the LL360 group (SLL 2.25 ± 0.51 mm; LL360 1.67 ± 0.37 mm; p = 0.01). Ultimate Load to Failure was significantly higher in the LL360 (168.6 ± 29.6 N) as compared to the SLL (124.1 ± 25.8 N, p = 0.02). The LL360 also revealed a significant higher stiffness compared to the SLL (SLL 13.1 ± 0.9 N/mm vs. LL360 19.1 ± 1.0 N/mm, p < 0.001). The most common mode of failure was the suture cutting through the tendon, with a significantly less suture cutting through for the LL360 compared with the SLL (p < 0.05).ConclusionThe LassoLoop360-technique offers superior biomechanical characteristics regarding the tendon-suture-interface compared to the SLL. In the initial healing phase, the suture-tendon-interface is the most vulnerable part of the tendon-suture-anchor construct, the aim of this new technique is to reduce this weakest part of the chain (Ponce et al., Am J Sports Med 39:188–194, 2011). This technique may therefore be beneficial for arthroscopic suprapectoral biceps tenodesis at the entrance of the bicipital groove01A - Beitrag in wissenschaftlicher Zeitschrift
- PublikationThree Anchors For Rotator Cuff Repair Biomechanically Compared In Standardized Physiological And Osteoporotic Bone(09/2018) Rosso, Claudio; de Wild, Michael; Dietschy, Alain; Weber, Timo; Müller, Sebastian06 - Präsentation
- PublikationEuropean Society of SportsTraumatology, Knee Surgery and Arthroscopy(05/2018) Rosso, Claudio; de Wild, Michael; Weber, Timo; Müller, Sebastian06 - Präsentation
- PublikationNew Lasso-Loop 360° Technique For Arthroscopic Suprapectoral Biceps Tenodesis – A Biomechanical Comparison(2016) de Wild, Michael; Rosso, Claudio; Müller, Sebastian; Flury, Rebekka; Zimmermann, Simon; Lafosse, Laurent; Bongiorno, Vito06 - Präsentation
- PublikationAll-inside meniscal repair devices compared with their matched inside-out Vertical mattress suture repair. Introducing 10,000 and 100,000 loading cycles(SAGE, 01.09.2014) Rosso, Claudio; Müller, Sebastian; Buckland, Daniel M.; Schwenk, Tanja; Zimmermann, Simon; de Wild, Michael; Valderrabano, Victor [in: The American Journal of Sports Medicine]All-inside arthroscopic meniscal repairs are favored by most clinicians because of their lower complication rate and decreased morbidity compared with inside-out techniques. Until now, only 1000 cycles have been used for biomechanical testing. Hypothesis: All-inside meniscal repairs will show inferior biomechanical response to cyclic loading (up to 100,000 cycles) and load-to-failure testing compared with inside-out suture controls. Study Design: Controlled laboratory study. Methods: Bucket-handle tears in 72 porcine menisci were repaired using the Omnispan and Fast-Fix 360 (all-inside devices) and Orthocord 2-0 and Ultrabraid 2-0 sutures (matched controls). Initial displacement, displacement after cyclic loading (100, 500, 1000, 2000, 5000, 10,000, and 100,000 cycles) between 5 and 20 N, ultimate load to failure, and mode of failure were recorded, as well as stiffness. Results: Initial displacement and displacement after cyclic loading were not different between the groups. The Omnispan repair demonstrated the highest load-to-failure force (mean 6 SD, 151.3 6 21.5 N) and was significantly stronger than all the other constructs (Orthocord 2-0, 105.5 6 20.4 N; Ultrabraid 2-0, 93.4 6 22.5 N; Fast-Fix 360, 76.6 6 14.2 N) (P \ .0001 for all). The Orthocord vertical inside-out mattress repair was significantly stronger than the Fast-Fix 360 repair (P = .003). The Omnispan (30.8 6 3.5 N/mm) showed significantly higher stiffness compared with the Ultrabraid 2-0 (22.9 6 6.9 N/mm, P \ .0001) and Fast-Fix 360 (23.7 6 3.9 N/mm, P = .001). The predominant mode of failure was suture failure. Conclusion: All-inside meniscal devices show comparable biomechanical properties compared with inside-out suture repair in cyclic loading, even after 100,000 cycles. Clinical Relevance: Eight to 10 weeks of rehabilitation might not pose a problem for all repairs in this worst-case scenario.01A - Beitrag in wissenschaftlicher Zeitschrift