Kocabey Yavuz, Taser Omer, Nyland John, Doral Mahmut Nedim, Demirhan Mehmet, Caborn David N M, Sarban Sezgin
Department of Orthopaedics and Traumatology, Besni Government Hospital, Adiyaman, Turkey.
Knee Surg Sports Traumatol Arthrosc. 2006 Oct;14(10):998-1003. doi: 10.1007/s00167-006-0079-9. Epub 2006 May 4.
This in vitro biomechanical study with cyclic loading compared the pullout strength of vertical, horizontal, and oblique sutures used for meniscal lesion repair. Following repair of vertical longitudinal lesions created in bovine medial menisci, three groups of seven specimens (vertical, horizontal, and oblique sutures) underwent cyclic loading in a randomized test order (5 mm/min, cycling between 5 and 50 N at 1 Hz for 100 cycles) prior to load to failure testing (5 mm/min). Displacement did not differ between groups during cyclic or load to failure testing. Construct stiffness during cyclic testing was superior for the oblique suture (6.9 +/- 1.5 N/mm, P = 0.007) and the vertical suture (6.4 +/- 7 N/mm, P = 0.03) groups compared to the horizontal suture group (4.4 +/- 0.52 N/mm). The oblique suture (171.9 +/- 25.9 N, P < 0.0001) and the vertical suture (145.9 +/- 32.3 N, P = 0.001) groups displayed superior load at failure compared to the horizontal suture group (88.8 +/- 8.2 N). Construct stiffness during load to failure testing did not differ between groups. Suture rupture was the failure mode for all specimens of the oblique suture group. Suture rupture was the failure mode for 57% (4/7) of the vertical suture group with the remaining specimens (3/7, 43%) failing from intact suture pullout through meniscal tissue. All horizontal suture group specimens failed by intact suture pulling through meniscal tissue. With comparable stiffness during cyclic testing, comparable load at failure as vertical sutures, and less evidence of intact suture pullout through the meniscus, an oblique suture technique may combine the beneficial characteristics of vertical (superior biomechanical strength) and horizontal (ease of application, longer sutures with a tendency to cover a larger meniscal tissue area) suture-repair techniques.
这项采用循环加载的体外生物力学研究比较了用于半月板损伤修复的垂直、水平和斜向缝合线的拔出强度。在修复牛内侧半月板产生的垂直纵向损伤后，三组各七个标本（垂直、水平和斜向缝合线）按照随机测试顺序进行循环加载（5毫米/分钟，在1赫兹下于5至50牛之间循环100次），然后进行破坏载荷测试（5毫米/分钟）。在循环或破坏载荷测试期间，各组之间的位移没有差异。与水平缝合线组（4.4±0.52牛/毫米）相比，斜向缝合线组（6.9±1.5牛/毫米，P = 0.007）和垂直缝合线组（6.4±7牛/毫米，P = 0.03）在循环测试期间的结构刚度更高。与水平缝合线组（88.8±8.2牛）相比，斜向缝合线组（171.9±25.9牛，P < 0.0001）和垂直缝合线组（145.9±32.3牛，P = 0.001）在破坏时的载荷更高。在破坏载荷测试期间，各组之间的结构刚度没有差异。斜向缝合线组的所有标本的失效模式均为缝合线断裂。垂直缝合线组57%（4/7）的标本的失效模式为缝合线断裂，其余标本（3/7，43%）因完整缝合线从半月板组织中拔出而失效。水平缝合线组的所有标本均因完整缝合线从半月板组织中拔出而失效。由于在循环测试期间具有可比的刚度、与垂直缝合线相当的破坏载荷以及较少的完整缝合线从半月板中拔出的证据，斜向缝合线技术可能结合了垂直（生物力学强度更高）和水平（应用简便、缝线更长且倾向于覆盖更大的半月板组织区域）缝合修复技术的有益特性。
