Barber F Alan, Coons David A, Ruiz-Suarez Michell
Plano Orthopedic and Sports Medicine Center, Plano, Texas 75093, USA.
Arthroscopy. 2007 Apr;23(4):355-60. doi: 10.1016/j.arthro.2006.12.009.
The purpose of this study was to test 4 different biodegradable suture anchors threaded with 2 high-strength sutures under cyclic loading conditions in humeral cadaveric specimens divided into 2 different age groups.
Thirty-two paired human cadaveric humeri were stripped of all soft tissue. Two groups were studied: group 1, in which the mean age was 54 years, and group 2, in which the mean age was 70 years. We placed 1 suture anchor at 3 humeral sites per bone (anterior, middle, and posterior greater tuberosity). We tested 24 specimens using each of 4 anchors: TwinFix AB (Smith & Nephew Endoscopy, Andover, MA), BioZip (Stryker Endoscopy, San Jose, CA), Bio-Corkscrew FT (Arthrex, Naples, FL), and SpiraLok (DePuy Mitek, Raynham, MA). The anchor's sutures were grasped with an Instron clamp (Instron, Canton, MA), preloaded, and cycled from 10 to 60 N 500 times, followed by destructive testing. The mean displacement at 500 cycles, yield loads, failure modes, and ultimate loads were recorded.
Most cyclic motion occurred during the first 100 cycles. More motion occurred in older bones than in younger bones (P < .05). The mean yield loads were greater for the young group for the SpiraLok anchors than for Bio-Corkscrew FT anchors in the young and old groups (P < .001), TwinFix anchors in the old group (P < .05), and BioZip anchors in the old group (P < .05). The ultimate failure loads for SpiraLok anchors in the young group were greater than for Bio-Corkscrew FT anchors in the young and old groups and BioZip anchors in the old group (P < .05). In group 1 TwinFix AB (P = .01) and BioZip (P = .02) ultimate loads were statistically greater than that for Bio-Corkscrew FT. The TwinFix AB failed by anchor pullout. The Bio-Corkscrew FT failed by eyelet pullout. The BioZip and SpiraLok pulled out in older bone and experienced eyelet breakage in younger bone. None of the 4 anchors reached 5 mm of displacement even after 500 loading cycles.
Most of the displacement occurred in the first 100 cycles. Of all anchors tested, the Bio-Corkscrew FT recorded the lowest displacement after 500 cycles (P < .05). The SpiraLok had the highest ultimate load of all anchors tested (P < .01).
Rotator cuff anchors perform differently in younger humeral bone than in older humeral bone. Most displacement with cyclic loading occurring between the anchor and bone takes place in the first 100 cycles. Anchors in older bones can be expected to fail at lower loads.
本研究旨在对4种不同的、穿有2根高强度缝线的可生物降解缝线锚钉进行测试，这些锚钉在循环加载条件下，应用于分为2个不同年龄组的肱骨尸体标本。
32对人尸体肱骨被剥离所有软组织。研究了2组：第1组，平均年龄54岁；第2组，平均年龄70岁。每根骨头在3个肱骨部位（大结节前、中、后部）各放置1个缝线锚钉。使用4种锚钉中的每一种对24个标本进行测试：TwinFix AB（史赛克内窥镜公司，马萨诸塞州安多弗）、BioZip（史赛克内窥镜公司，加利福尼亚州圣何塞）、Bio-Corkscrew FT（ Arthrex公司，佛罗里达州那不勒斯）和SpiraLok（DePuy Mitek公司，马萨诸塞州雷纳姆）。用Instron夹具（Instron公司，马萨诸塞州坎顿）夹住锚钉的缝线，进行预加载，并在10至60 N之间循环500次，随后进行破坏性测试。记录500次循环时的平均位移、屈服载荷、失效模式和极限载荷。
大部分循环运动发生在前100次循环中。老年组骨头比年轻组骨头出现更多运动（P < 0.05）。在年轻组中，SpiraLok锚钉的平均屈服载荷高于Bio-Corkscrew FT锚钉在年轻组和老年组中的值（P < 0.001）、高于TwinFix锚钉在老年组中的值（P < 0.05）以及高于BioZip锚钉在老年组中的值（P < 0.05）。年轻组中SpiraLok锚钉的极限破坏载荷高于Bio-Corkscrew FT锚钉在年轻组和老年组中的值以及BioZip锚钉在老年组中的值（P < 0.05）。在第1组中，TwinFix AB（P = 0.01）和BioZip（P = 0.02）的极限载荷在统计学上高于Bio-Corkscrew FT的极限载荷。TwinFix AB因锚钉拔出而失效。Bio-Corkscrew FT因小孔拔出而失效。BioZip和SpiraLok在老年组骨头中拔出，在年轻组骨头中出现小孔断裂。即使经过500次加载循环，4种锚钉中没有一种达到5 mm的位移。
大部分位移发生在前100次循环中。在所有测试的锚钉中，Bio-Corkscrew FT在500次循环后记录的位移最低（P < 0.05）。SpiraLok在所有测试锚钉中具有最高的极限载荷（P < 0.01）。
肩袖锚钉在年轻肱骨中的表现与在老年肱骨中的表现不同。锚钉与骨头之间在循环加载时的大部分位移发生在前100次循环中。预计老年组骨头中的锚钉在较低载荷下失效。
