Golish S Raymond, Caldwell Paul E, Miller Mark D, Singanamala Naveen, Ranawat Anil S, Treme Gehron, Pearson Sara E, Costic Ryan, Sekiya Jon K
Department of Orthopaedic Surgery, University of Virginia, Charlottesville, Virginia,USA.
Arthroscopy. 2008 Oct;24(10):1103-8. doi: 10.1016/j.arthro.2008.05.005. Epub 2008 Jun 16.
The purpose of this study was to compare the biomechanical properties of 2 fixation methods for subpectoral proximal biceps tenodesis.
In 9 matched pairs of cadaveric shoulders, an open subpectoral tenodesis was performed 1 cm proximal to the inferior border of the pectoralis major tendon by use of either an 8 x 12-mm Bio-Tenodesis screw (Arthrex, Naples, FL) with No. 2 FiberWire sutures (Arthrex) or a 5.5-mm Bio-Corkscrew double-loaded suture anchor (Arthrex) with No. 2 FiberWire sutures. The specimens were dissected and mounted in a material testing machine. Cyclic loading (20 to 60 N, 100 cycles, 0.5 mm/s, 5-N preload) was performed, followed by an unloaded 30-minute rest, a 5-N preload, and a load-to-failure protocol (1.25 mm/s) with a 100-lb load cell. Ultimate load (in Newtons), stiffness (in Newtons per millimeter), and modes of failure were recorded. Data were analyzed by use of paired t tests and Wilcoxon signed rank tests.
Proximal biceps tenodeses with Bio-Tenodesis screws had a significantly higher mean load to failure (169.6 +/- 50.5 N; range, 99.6 to 244.7 N) than those with Bio-Corkscrew suture anchors (68.5 +/- 33.0 N; range, 24.2 to 119.4 N) (P = .002). Bio-Tenodesis screws also had a significantly higher stiffness (34.1 +/- 9.0 N/mm; range, 20.6 to 48.9 N/mm) than Bio-Corkscrews (19.3 +/- 10.5; range, 5.9 to 32.9 N/mm) (P = .038).
In this cadaveric study the Bio-Tenodesis screw showed a statistically significantly higher load to failure and significantly higher stiffness than the Bio-Corkscrew anchor when used for tenodesis of the proximal biceps tendon in a subpectoral location.
Biomechanical comparison of these 2 fixation techniques provides information on stiffness and load to failure of alternate fixation methods.
本研究旨在比较胸大肌下近侧肱二头肌固定术两种固定方法的生物力学特性。
在9对匹配的尸体肩部标本中，于胸大肌腱下缘近端1 cm处进行开放性胸大肌下固定术，分别使用8×12 mm生物固定螺钉（美国佛罗里达州那不勒斯市阿特瑞斯公司）及2号纤维线缝线（阿特瑞斯公司），或5.5 mm双股生物螺旋缝线锚钉（阿特瑞斯公司）及2号纤维线缝线。将标本解剖后安装于材料试验机上。先进行循环加载（20至60 N，100个循环，0.5 mm/s，5 N预加载），随后空载休息30分钟，再进行5 N预加载，接着采用100磅测力传感器按加载至破坏方案（1.25 mm/s）加载。记录极限载荷（牛顿）、刚度（牛顿/毫米）及破坏模式。数据采用配对t检验和威尔科克森符号秩检验进行分析。
使用生物固定螺钉的近侧肱二头肌固定术的平均破坏载荷（169.6±50.5 N；范围99.6至244.7 N）显著高于使用生物螺旋缝线锚钉的固定术（68.5±33.0 N；范围24.2至119.4 N）（P = 0.002）。生物固定螺钉的刚度（34.1±9.0 N/mm；范围20.6至48.9 N/mm）也显著高于生物螺旋缝线锚钉（19.3±10.5；范围5.9至32.9 N/mm）（P = 0.038）。
在本尸体研究中，当用于胸大肌下位置的近侧肱二头肌腱固定术时，生物固定螺钉的破坏载荷在统计学上显著高于生物螺旋缝线锚钉，且刚度也显著更高。
这两种固定技术的生物力学比较为替代固定方法的刚度和破坏载荷提供了信息。
