Overcoming Challenges With Metal Cerclage Cables

In the US, the number of hip and upper extremity fixation procedures are expected to reach approximately 240,000 in 2022 and increase at a CAGR of approximately 7.4% in the coming years [1]. The techniques typically used in these procedures combine rigid plates, cables, and tooling. For decades, metal cables and fixations have been used in spine and trauma corrective surgeries to hold together bone.

Although in many instances metal cerclage cables work well, there are some inherent difficulties with them that need to be tolerated.  For example, metal can wear over time and generate small particles that can lead to irritation.  Metal cables can also be sharp, especially at the cut ends if they need to be removed, and they are also fairly bulky which can lead to irritation. 

Recently, polymer cerclage cables have begun to take market share due to an accumulation of smaller benefits relative to traditional metallic cables. Primary requirements for such cables are typically size, strength, stiffness, and of course biocompatibility, but there are also important secondary considerations. These include but are not limited to cable flexibility, fatigue performance, creep, ease of handling, abrasion resistance, the ability to fix ends of the cable, ease of visualization, operator and patient comfort, and finally ease of surgical procedure.