Ozalay Metin, Akpinar Sercan, Karaeminogullari Oguz, Balcik Cenk, Tasci Arzu, Tandogan Reha N, Gecit Rusen
Department of Orthopaedics and Traumatology, Adana Medical Center, Baskent University School of Medicine, Turkey.
Arthroscopy. 2005 Aug;21(8):992-8. doi: 10.1016/j.arthro.2005.05.002.
The aim of this study was to compare the biomechanical properties of 4 different biceps tenodesis techniques.
Biomechanical experiment.
Four groups of fresh sheep shoulders (28 total) with similar shape characteristics were used. Biceps tenodesis was performed using the following techniques: group 1 (n = 7), tunnel technique; group 2 (n = 7), interference screw technique; group 3 (n = 7), anchor technique; and group 4 (n = 7), keyhole technique. Each construct was loaded to failure and the groups were compared with respect to maximum load in Newtons and deflection at maximum load in millimeters. The results were statistically analyzed with 1-way analysis of variance, the Bonferroni post hoc test and the Student t test or the nonparametric Mann-Whitney U test.
The calculated average maximum loads were 229.2 +/- 44.1 N for the tunnel technique, 243.3 +/- 72.4 N for the interference screw, 129.0 +/- 16.6 N for the anchor technique, and 101.7 +/- 27.9 N for the keyhole technique. Statistical testing showed no statistically significant differences between groups 1 and 2, groups 3 and 4, or groups 2 and 3 with respect to maximum load and deflection at maximum load (P = .09/P = .49, P = .41/P = .79, and P = .06/P = .82 for load/deflection in the 3 comparisons, respectively). However, all other group comparisons revealed significant differences for both parameters (group 1 v group 4 [P < .01/P < .01]; group 1 v group 3[P < .01/P = .01]; and group 2 v group 4 [P = .007/P = .003]).
The strongest construct was made with the interference screw technique, followed by the tunnel, anchor, and keyhole techniques. There were no statistically significant differences between the interference screw and tunnel techniques with respect to maximum load or deflection at maximum load.
Although it is difficult to extrapolate in vitro data to the clinical situation, the interference screw technique has better initial biomechanical properties and may produce improved clinical outcomes.
本研究旨在比较4种不同肱二头肌肌腱固定技术的生物力学特性。
生物力学实验。
使用四组形状特征相似的新鲜绵羊肩部（共28个）。采用以下技术进行肱二头肌肌腱固定：第1组（n = 7），隧道技术；第2组（n = 7），干涉螺钉技术；第3组（n = 7），锚钉技术；第4组（n = 7），锁孔技术。对每个结构加载直至破坏，并比较各组在牛顿单位下的最大载荷以及在最大载荷下以毫米为单位的挠度。结果采用单因素方差分析、Bonferroni事后检验以及Student t检验或非参数Mann-Whitney U检验进行统计学分析。
隧道技术计算出的平均最大载荷为229.2±44.1 N，干涉螺钉技术为243.3±72.4 N，锚钉技术为129.0±16.6 N，锁孔技术为101.7±27.9 N。统计学检验显示，在最大载荷及最大载荷下的挠度方面，第1组和第2组、第3组和第4组、第2组和第3组之间均无统计学显著差异（3次比较中，载荷/挠度的P值分别为0.09/0.49、0.41/0.79和0.06/0.82）。然而，所有其他组间比较在这两个参数上均显示出显著差异（第1组与第4组[P < 0.01/P < 0.01]；第1组与第3组[P < 0.01/P = 0.01]；第2组与第4组[P = 0.007/P = 0.003]）。
最强的结构是采用干涉螺钉技术构建的，其次是隧道技术、锚钉技术和锁孔技术。干涉螺钉技术与隧道技术在最大载荷或最大载荷下的挠度方面无统计学显著差异。
尽管很难将体外数据外推至临床情况，但干涉螺钉技术具有更好的初始生物力学特性，可能会产生更好的临床结果。
