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II型SLAP损伤的无结锚钉修复与单纯缝线修复的生物力学比较

Biomechanical comparison of knotless anchor repair versus simple suture repair for type II SLAP lesions.

作者信息

Uggen Christopher, Wei Anthony, Glousman Ronald E, ElAttrache Neal, Tibone James E, McGarry Michelle H, Lee Thay Q

机构信息

Kerlan-Jobe Orthopaedic Clinic, Los Angeles, California, USA.

出版信息

Arthroscopy. 2009 Oct;25(10):1085-92. doi: 10.1016/j.arthro.2009.03.022. Epub 2009 Aug 22.

Abstract

PURPOSE

The purpose of this study was to evaluate glenohumeral motion after knotless anchor repair of type II SLAP lesions versus repair with simple suture arthroscopic knot-tying techniques and to compare the initial fixation strength of the 2 repair techniques.

METHODS

Six matched-pair cadaveric shoulders were tested in an uninjured condition, after creation of a type II SLAP tear, and after repair with either a knotless repair with two 3.5-mm Bio-PushLock anchors (Arthrex, Naples, FL) or a simple suture repair with two 3.0-mm Bio-SutureTak anchors (Arthrex) placed anterior and posterior to the biceps tendon. Glenohumeral rotation, translation, and kinematics were measured. The SLAP repairs were then loaded to failure perpendicular to the glenoid face.

RESULTS

Glenohumeral rotation increased after creation of a type II SLAP lesion and was restored to the intact state after both repairs. There was no significant difference in glenohumeral translation or kinematics with SLAP lesion or either repair technique. There was no significant difference between stiffness, yield load, or ultimate load of the 2 repairs. Simple suture repairs failed most commonly by knot breakage, and knotless repairs failed by suture slippage around the anchor.

CONCLUSIONS

Knotless anchor repairs of type II SLAP lesions restore glenohumeral rotation as well as simple suture arthroscopic repair techniques without overconstraining the shoulder. In addition, the initial fixation strength of knotless anchor repairs of type II SLAP lesions is similar to that of simple suture repairs.

CLINICAL RELEVANCE

Knotless anchor repairs of type II SLAP lesions restore capsulolabral anatomy without overconstraining the shoulder.

摘要

目的

本研究旨在评估Ⅱ型肩胛下肌上盂唇从前到后(SLAP)损伤采用无结锚钉修复与简单缝线关节镜打结技术修复后的盂肱关节活动情况,并比较两种修复技术的初始固定强度。

方法

对六对匹配的尸体肩部进行测试,测试状态分别为未受伤状态、制造Ⅱ型SLAP撕裂后、以及采用两个3.5毫米生物推锁锚钉(Arthrex公司,那不勒斯,佛罗里达州)进行无结修复或采用两个3.0毫米生物缝线锚钉(Arthrex公司)在二头肌腱前后进行简单缝线修复后。测量盂肱关节的旋转、平移和运动学情况。然后将SLAP修复结构垂直于关节盂面加载直至失效。

结果

制造Ⅱ型SLAP损伤后盂肱关节旋转增加,两种修复后均恢复到完整状态。SLAP损伤或任何一种修复技术在盂肱关节平移或运动学方面均无显著差异。两种修复结构在刚度、屈服载荷或极限载荷方面无显著差异。简单缝线修复最常见的失效方式是结断裂,无结修复的失效方式是锚钉周围缝线滑移。

结论

Ⅱ型SLAP损伤的无结锚钉修复与简单缝线关节镜修复技术一样能恢复盂肱关节旋转,且不会过度限制肩关节。此外,Ⅱ型SLAP损伤的无结锚钉修复的初始固定强度与简单缝线修复相似。

临床意义

Ⅱ型SLAP损伤的无结锚钉修复可恢复关节囊盂唇解剖结构,且不会过度限制肩关节。

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