Zhao Chunfeng, Sun Yu-Long, Zobitz Mark E, An Kai-Nan, Amadio Peter C
Biomechanics Laboratory, Division of Orthopedic Research, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
J Hand Surg Am. 2007 May-Jun;32(5):606-11. doi: 10.1016/j.jhsa.2007.03.004.
Preventing gap or rupture is important to achieving a successful outcome after tendon repair. Weak sutures break; strong sutures fail by pull-out at the tendon-suture interface. In this study, we investigated the use of 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide hydrochloride (EDC) and cyanoacrylate to enhance the strength of the tendon-suture interface.
Twenty-four canine flexor digitorum profundus tendons were used to test EDC and cyanoacrylate reinforcement methods, with 12 tendons in each group. A single-loop suture technique was used to test the tendon-suture interface strength.
The mean ultimate strengths of the EDC group and the cyanoacrylate group were significantly higher than those of their respective control groups. The stiffness of the group with cyanoacrylate-augmented loops was significantly higher than that of its respective control group. There was no significant difference in stiffness between the 2 reinforcement methods.
Our results suggest that tendon-suture interface reinforcement may improve the pull-out failure strength of a suture construct and thereby increase the effectiveness of stronger suture materials. Future studies might address the effects of different kinds and methods of reinforcement with various suture materials and constructs and in different tissues.
预防间隙或破裂对于肌腱修复术后取得成功的结果很重要。薄弱的缝线会断裂；坚固的缝线则会在肌腱-缝线界面处因拔出而失效。在本研究中，我们研究了使用盐酸1-乙基-3-(3-二甲基氨基丙基)碳二亚胺（EDC）和氰基丙烯酸酯来增强肌腱-缝线界面的强度。
使用24条犬的趾深屈肌腱来测试EDC和氰基丙烯酸酯增强方法，每组12条肌腱。采用单环缝合技术测试肌腱-缝线界面强度。
EDC组和氰基丙烯酸酯组的平均极限强度显著高于各自的对照组。氰基丙烯酸酯增强环组的刚度显著高于其各自的对照组。两种增强方法之间的刚度无显著差异。
我们的结果表明，肌腱-缝线界面增强可能会提高缝线结构的拔出失效强度，从而提高更强缝线材料的有效性。未来的研究可能会探讨不同种类和方法的增强对各种缝线材料和结构以及在不同组织中的影响。
