Englert Carsten, Fierlbeck Johann, von Glasser Sabine Schulz, Nerlich Michael, Hammer Joachim
Department of Trauma Surgery, Regensburg University Medical Center, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany.
Clin Biomech (Bristol). 2007 Aug;22(7):849-55. doi: 10.1016/j.clinbiomech.2007.04.008. Epub 2007 Jun 13.
Sutures for adaptation of articular cartilage are used in arthritis therapy techniques. However, little is known about the mechanical functionality of these sutures. The objective of the present work was to compare the mechanical properties of articular cartilage bonds either generated by suture, or, alternatively, by chemical cross-linking of the opposing surfaces or in vitro integrative repair of cartilage blocks.
Bonding was achieved by suture in varying numbers, positions and orientations, by surface cross-linking using carbodiimide in combination with pepsin or guanidine (immediate bonding), or by cultivation for 14 days, either with or without testosterone. The mechanical properties of the cartilage bonds were measured under tensile loading.
Suture led to the highest maximal load at failure and by far to the highest strain and lowest stiffness of the bonded samples. Immediate bonding by chemical cross-linking in combination with pepsin led to a low force at failure, but the highest stiffness, as compared to all other groups. Cultivation in the presence of testosterone led to a higher force at failure and a higher strain than chemical cross-linking.
Suture technique for bonding of cartilage surfaces leads to a very elastic adaptation which allows synovial fluid flow in between the interface of cartilage wounds. Long-term bonding of cartilage wounds would be counteracted by a fluid flow through the interface during motion of the joint. Immediate bonding of cartilage wounds by chemical cross-linking reagents might be a useful alternative tool. Even more promising, with regard to the mechanical properties, appears to be integrative repair of cartilage blocks stimulated by testosterone.
用于关节软骨适配的缝线被应用于关节炎治疗技术中。然而,对于这些缝线的机械功能却知之甚少。本研究的目的是比较通过缝线、相对表面化学交联或软骨块体外整合修复所产生的关节软骨结合的力学性能。
通过不同数量、位置和方向的缝线、使用碳二亚胺与胃蛋白酶或胍进行表面交联(即时结合)、或在有或无睾酮的情况下培养14天来实现结合。在拉伸载荷下测量软骨结合的力学性能。
缝线导致结合样本在失效时的最大载荷最高,且结合样本的应变最高、刚度最低。与所有其他组相比,使用碳二亚胺与胃蛋白酶进行化学交联的即时结合导致失效时的力较低,但刚度最高。在睾酮存在的情况下培养导致失效时的力和应变高于化学交联。
软骨表面结合的缝线技术会产生非常有弹性的适配,这允许滑液在软骨伤口界面之间流动。在关节运动过程中,通过界面的流体流动会抵消软骨伤口的长期结合。用化学交联试剂即时结合软骨伤口可能是一种有用的替代方法。就力学性能而言,由睾酮刺激的软骨块整合修复似乎更有前景。