Coons David A, Barber F Alan, Herbert Morley A
Plano Orthopedic and Sports Medicine Center, 5228 West Plano Pkwy, Plano, TX 75093, USA.
Arthroscopy. 2006 Nov;22(11):1154-8. doi: 10.1016/j.arthro.2006.05.020.
This study evaluated the strength and suture-tendon interface security of different suture configurations from triple-suture-loaded anchors.
A juvenile bovine infraspinatus tendon was detached and repaired by use of 4 different suture combinations from 2 suture anchors: 3 simple sutures in each anchor (ThreeVo anchor; Linvatec, Largo, FL); 2 peripheral simple stitches and 1 central horizontal mattress suture passed deeper into the tendon, creating a larger footprint (bigfoot-print anchor); 2 peripheral simple stitches with 1 central horizontal mattress stitch passed through the same holes as the simple sutures (stitch-of-Burns); and 2 simple stitches (TwoVo anchor; Linvatec). The constructs were cyclically loaded between 10 N and 180 N for 3,500 cycles and then destructively tested. The number of cycles required to create a 5-mm gap and a 10-mm gap and the ultimate load to failure and failure mode were recorded.
The ThreeVo anchor was strongest and most resistant to cyclic loading (P < .01). The TwoVo anchor was least resistant to cyclic loading. The stitch-of-Burns anchor was more resistant to cyclic loading than both the bigfoot-print anchor and the TwoVo anchor (P < .03). The ThreeVo, stitch-of-Burns, and TwoVo anchors were stronger than the bigfoot-print anchor (P < .05).
Three simple sutures in an anchor hold better than two simple sutures. Three simple sutures provide superior suture-tendon security than combinations of one mattress and two simple stitches subjected to cyclic loading. A central mattress stitch placed more medially than two peripheral simple stitches (bigfoot-print anchor) configured to enlarge the tendon-suture footprint was not as resistant to cyclic loading or destructive testing as three simple stitches (ThreeVo anchor).
Placing a central mattress stitch more medially than 2 peripheral simple stitches to enlarge the tendon-suture footprint was not as resistant to cyclic loading or destructive testing as 3 simple stitches.
本研究评估了三缝线加载锚钉的不同缝线构型的强度和缝线与肌腱界面的安全性。
将幼年牛的冈下肌腱切断，使用来自2种缝线锚钉的4种不同缝线组合进行修复：每个锚钉中有3根单纯缝线（ThreeVo锚钉；Linvatec公司，拉戈，佛罗里达州）；2根周边单纯缝线和1根穿过肌腱更深部位的中央水平褥式缝线，形成更大的接触面积（大脚接触面积锚钉）；2根周边单纯缝线和1根中央水平褥式缝线穿过与单纯缝线相同的孔（Burns缝合法）；以及2根单纯缝线（TwoVo锚钉；Linvatec公司）。对这些构建物在10 N至180 N之间进行3500次循环加载，然后进行破坏性测试。记录产生5 mm间隙和10 mm间隙所需的循环次数、最终破坏载荷以及破坏模式。
ThreeVo锚钉最强且最能抵抗循环加载（P < 0.01）。TwoVo锚钉对循环加载的抵抗力最小。Burns缝合法锚钉比大脚接触面积锚钉和TwoVo锚钉更能抵抗循环加载（P < 0.03）。ThreeVo、Burns缝合法和TwoVo锚钉比大脚接触面积锚钉更强（P < 0.05）。
锚钉中的3根单纯缝线比2根单纯缝线固定效果更好。与循环加载下1根褥式缝线和2根单纯缝线的组合相比，3根单纯缝线提供了更好的缝线与肌腱的安全性。与3根单纯缝线（ThreeVo锚钉）相比，配置为扩大肌腱 - 缝线接触面积的中央褥式缝线置于比2根周边单纯缝线更内侧时，对循环加载或破坏性测试的抵抗力较弱。
与3根单纯缝线相比，将中央褥式缝线置于比2根周边单纯缝线更内侧以扩大肌腱 - 缝线接触面积时，对循环加载或破坏性测试的抵抗力较弱。
