Bicknell Ryan T, Harwood Chris, Ferreira Louis, King Graham J W, Johnson James A, Faber Ken, Drosdowech Darren
Department of Surgery, University of Western Ontario, London, Ontario, Canada.
Arthroscopy. 2005 Jul;21(7):875-80. doi: 10.1016/j.arthro.2005.03.009.
This study compares rotator cuff repair strength after cyclic loading of bioabsorbable tacks and traditional transosseous sutures, and correlates the results with bone density, age, and gender. The hypotheses were that tack repair strength would be inferior to transosseous sutures and that repair strength would be directly related to bone quality.
In vitro randomized biomechanical study.
Eight paired cadaveric shoulders with a standardized supraspinatus defect were randomized to tack or suture repair and subjected to step-wise cyclic loading. Repair migration was measured by quantifying the motion of markers affixed to tendon and bone using a digital camera. Failure mode, cycles, and load were measured for 50% and 100% loss of repair. Results were correlated with bone density, age, and gender.
Tack repairs failed at the tack-tendon interface, whereas suture rupture was the mode of failure for the suture repairs. Mean values for 50% loss of repair were 206 +/- 88 cycles and 44 +/- 15 N for the sutures, and 1,193 +/- 252 cycles and 156 +/- 20 N for the tacks (P < .05). The corresponding values for 100% loss of repair were 2,458 +/- 379 cycles and 294 +/- 27 N for the sutures, and 2,292 +/- 333 cycles and 263 +/- 28 N for the tacks (P > .05). These results did not correlate with bone density, age, or gender.
This study has shown that bioabsorbable tacks provide improved repair strength in comparison with traditional suture techniques. Repair strength did not correlate with bone quality, and this may be attributed to failure primarily through the repair construct or at the tack-tendon interface and not through bone. This report describes a new high-resolution optical method of measuring tendon repair strength that should be a useful model for future studies.
This study demonstrates the biomechanical advantages of a sutureless tack device for rotator cuff repair compared with a traditional augmented suture repair technique.
本研究比较了生物可吸收钉和传统骨隧道缝线在循环加载后肩袖修复的强度，并将结果与骨密度、年龄和性别进行关联。假设是钉修复强度低于骨隧道缝线，且修复强度与骨质直接相关。
体外随机生物力学研究。
八对具有标准化冈上肌缺损的尸体肩部被随机分配接受钉修复或缝线修复，并进行逐步循环加载。通过使用数码相机量化附着在肌腱和骨头上的标记物的运动来测量修复移位。测量修复损失50%和100%时的失效模式、循环次数和负荷。结果与骨密度、年龄和性别进行关联。
钉修复在钉-肌腱界面处失效，而缝线断裂是缝线修复的失效模式。修复损失50%时，缝线的平均值为206±88次循环和44±15牛，钉的平均值为1193±252次循环和156±20牛（P<.05）。修复损失100%时，缝线的相应值为2458±379次循环和294±27牛，钉的相应值为2292±333次循环和263±28牛（P>.05）。这些结果与骨密度、年龄或性别无关。
本研究表明，与传统缝线技术相比，生物可吸收钉提供了更高的修复强度。修复强度与骨质无关，这可能归因于主要通过修复结构或在钉-肌腱界面处失效，而非通过骨失效。本报告描述了一种测量肌腱修复强度的新的高分辨率光学方法，该方法应为未来的研究提供有用的模型。
本研究证明了与传统增强缝线修复技术相比，无结钉装置用于肩袖修复的生物力学优势。
