Biomechanical tensile test for capsule repair comparing suturing methods including interrupted, continuous, and barbed sutures

Abstract

Background: Capsule repair plays an important role in total joint arthroplasty. However, no biomechanical studies have indicated the optimal suturing methods and materials in capsule repair. This study aimed to evaluate the effectiveness of the suturing methods (interrupted and continuous sutures) and materials (Vicryl and Stratafix) for capsule repair using porcine skin specimens.

Methods: Three groups with eight porcine skin specimens were used as a surrogate for human capsules. The V-I group with 1-Vicryl interrupted sutures, V-C group with 1-Vicryl continuous sutures, and S group with 1-Stratafix continuous sutures were analyzed by tensile test to investigate the maximum failure load. Eight pieces of 1-Viclyl and nine pieces of 1-Stratafix were used to analyze the suture material's strength. Corrected maximum failure load was calculated by taking the ratio of the mean maximum tensile strengths of Vicryl and Stratafix sutures.

Findings: The maximum failure loads were 275.52 ± 62.45 N, 465.81 ± 57.91 N, and 303.08 ± 37.16 N in V-I, V-C, and S groups, respectively. Regarding the suture material's strength, 1-Vicryl showed significantly higher maximum failure load than 1-Stratafix (47.37 ± 4.58 N vs 35.62 ± 4.35 N). When normalizing the influence of different suture materials on tensile strength, the corrected maximum failure load was 207.17 ± 46.96 N in V-I group and 350.27 ± 43.55 N in V-C group.

Interpretation: Our findings showed that Stratafix, barbed continuous suture, could be an alternative option to conventional Vicryl suture for capsule repair.

Keywords: Barbed continuous suture; Biomechanical tensile test; Capsule repair; Suturing materials; Suturing methods.