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对于部分关节侧肩袖肌腱撕裂,原位经肌腱修复优于撕裂完全修复。

In situ transtendon repair outperforms tear completion and repair for partial articular-sided supraspinatus tendon tears.

作者信息

Gonzalez-Lomas Guillem, Kippe Matthew A, Brown Gabriel D, Gardner Thomas R, Ding Anthony, Levine William N, Ahmad Christopher S

机构信息

Center for Shoulder, Elbow, and Sports Medicine, Department of Orthopaedic Surgery, Columbia-Presbyterian Medical Center, New York, NY 10032, USA.

出版信息

J Shoulder Elbow Surg. 2008 Sep-Oct;17(5):722-8. doi: 10.1016/j.jse.2008.01.148. Epub 2008 Jun 16.

Abstract

This biomechanical study compared 2 repair techniques for high-grade, partial, articular-sided supraspinatus tendon tears of the rotator cuff: transtendon in situ repair and tear completion with repair. Standardized, 50% partial, articular-sided supraspinatus lesions were created in 10 pairs of matched fresh, frozen cadaveric shoulders: 10 underwent partial lesion repair with an in situ transtendon technique using 2 suture anchors. In the contralateral 10 shoulders, the partial lesion was converted to a full-thickness tear and repaired with a double-row technique, using 4 suture anchors. Cyclic loading to failure of the supraspinatus tendon was performed using a material testing machine. Gap formation was measured for each rotational position and each incremental load. The in situ transtendon repair had statistically significant less gapping (P = .0001) and higher mean ultimate failure strength (P = .0011) than the double-row repair. In situ transtendon repair was biomechanically superior to tear completion for partial, articular-sided supraspinatus tears.

摘要

这项生物力学研究比较了两种针对肩袖高级别、部分性、关节侧冈上肌腱撕裂的修复技术:经肌腱原位修复和完成撕裂后修复。在10对匹配的新鲜冷冻尸体肩部标本上制造标准化的、50%的关节侧冈上肌部分损伤:10例采用原位经肌腱技术,使用2枚缝合锚钉进行部分损伤修复。在对侧的10个肩部,将部分损伤转变为全层撕裂,采用双排技术,使用4枚缝合锚钉进行修复。使用材料试验机对冈上肌腱进行循环加载直至失效。测量每个旋转位置和每个递增负荷下的间隙形成情况。原位经肌腱修复在统计学上比双排修复具有显著更小的间隙(P = .0001)和更高的平均极限破坏强度(P = .0011)。对于部分性、关节侧冈上肌腱撕裂,原位经肌腱修复在生物力学上优于完成撕裂后修复。

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