NDLI: Validation of a Finite Element Model of the Mechanical Performance of Surgical Knots of Varying Topology

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Validation of a Finite Element Model of the Mechanical Performance of Surgical Knots of Varying Topology

Content Provider	The American Society of Mechanical Engineers (ASME) Digital Collection
Author	Arz, Y. Qwam Alden Andrew, G. Geeslin Peter, A. Gustafson
Copyright Year	2018
Abstract	Background: Knot tying is considered a basic surgical skill, however, there is no consensus on the best technique. Suture breakage and slippage are failure modes during surgical repair and are related to stress concentrations which cannot be easily established with physical testing. Few computational models exist that describe the effect of knot topology on the failure mechanism. The purpose of this study was to implement the finite element method to analyze the mechanical behavior of surgical sutures according to number of throws and to validate the model against experiments. Methods: Experiments and models of monofilament and multifilament sutures were conducted. Multiple throw knots were tested to failure in a laboratory setting and with corresponding finite element models. Gross loads were compared when the knot reached a localized material yield stress in the model or when failure occurred in laboratory tests that have the same suture topology. Results: The results of laboratory tests and corresponding finite element models of single throw knots were compared and found to be well correlated and consistent with existing literature in strength prediction and failure location. Moreover, single throw knots have reduced failure strengths relative to non-knotted suture approximately by 120 N for both monofilament and multifilament sutures, respectively. Clinical Relevance: This paper describes a model which can describe the initial failure process leading to knot failure. In addition, the model can evaluate the effect of knot topology on the mechanics of surgical suture. Numerically, no assessment has been completed of knot security (i.e., how likely the knot is to untie), therefore, clinical recommendations are premature. In the future, the results may provide a framework for choosing the suture and knot types for soft tissue repairs.
File Format	PDF
ISBN	9780791852026
DOI	10.1115/IMECE2018-87868
Volume Number	Volume 3: Biomedical and Biotechnology Engineering
Conference Proceedings	ASME 2018 International Mechanical Engineering Congress and Exposition
Language	English
Publisher Date	2018-11-09
Publisher Place	Pittsburgh, Pennsylvania, USA
Access Restriction	Subscribed
Subject Keyword	Equipment performance Mechanical behavior Topology Maintenance Finite element methods Security Stress Soft tissues Finite element model Surgery Yield stress Failure Failure mechanisms Testing
Content Type	Text
Resource Type	Article

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