Biomechanical comparison of six suture configurations using a large diameter polyester prosthesis in the muscular process of the equine arytenoid cartilage.

The research compares the strength and durability of six different suture arrangements using a large diameter polyester material in a part of horse’s throat cartilage. The results suggest that using multiple sutures provides a more durable connection, and placing them strategically enhances the overall strength of the throat structure.

Methods

• The researchers conducted an experimental study using 121 deceased horse larynx samples.
• Six varied suture configurations (four single, two double) were inserted into the muscular process (MP) of the arytenoid cartilage in each sample.
• Each of these structures was then put through a single-cycle failure test under a 100mm per minute distraction.
• The researchers generated load deformation curves to assess the biomechanical properties of each individual construct.
• They used different statistical tests (a 1-way ANOVA, a 2-sample t-test, and a Fisher’s exact test) to compare the different variables—force required for construct failure, cricoarytenoid joint disarticulation force, and energy stored at failure—and establish statistical significance among the differences noticed.

Results

• The results showed that both, the construct as well as cricoarytenoid joint failure forces were significantly higher for double suture configurations compared to single suture patterns. This suggests that using multiple sutures can provide greater strength.
• However, there were no significant differences in the energy stored at the point of construct failure across different suture configurations.
• The researchers observed that failure at the muscular process (MP) accounted for at least half of the construct failures in three of the single suture patterns and one of the double suture patterns tested.
• The remaining two patterns exhibited a higher frequency of clamp failures and also failure of the cricoid cartilage, which is another critical part of the larynx structure.

Conclusions

• The researchers concluded that sutures that adequately engage the spine of the MP, either independently or in conjunction with a second suture, smwere biomechanically superior and provided a stronger construct.
• It suggests that engaging the spine of the MP results in the most biomechanically sound laryngeal construct, potentially offering a more effective suture configuration for surgeries in this area.