Plano Orthopedic Sports Medicine and Spine Center, Plano, Texas 75093, USA.
Arthroscopy. 2010 Mar;26(3):316-23. doi: 10.1016/j.arthro.2009.07.019. Epub 2009 Dec 29.
To evaluate the strength and suture-tendon interface security of various suture anchors triply and doubly loaded with ultrahigh-molecular weight polyethylene-containing sutures and to evaluate the relative effectiveness of placing these anchors in a single-row or double-row arrangement by cyclic loading and then destructive testing.
The infraspinatus muscle was reattached to the original humeral footprint by use of 1 of 5 different repair patterns in 40 bovine shoulders. Two single-row repairs and three double-row repairs were tested. High-strength sutures were used for all repairs. Five groups were studied: group 1, 2 triple-loaded screw suture anchors in a single row with simple stitches; group 2, 2 triple-loaded screw anchors in a single row with simple stitches over a fourth suture passed perpendicularly ("rip-stop" stitch); group 3, 2 medial and 2 lateral screw anchors with a single vertical mattress stitch passed from the medial anchors and 2 simple stitches passed from the lateral anchors; group 4, 2 medial double-loaded screw anchors tied in 2 mattress stitches and 2 push-in lateral anchors capturing the medial sutures in a "crisscross" spanning stitch; and group 5, 2 medial double-loaded screw anchors tied in 2 mattress stitches and 2 push-in lateral anchors creating a "suture-bridge" stitch. The specimens were cycled between 10 and 180 N at 1.0 Hz for 3,500 cycles or until failure. Endpoints were cyclic loading displacement (5 and 10 mm), total displacement, and ultimate failure load.
A single row of triply loaded anchors was more resistant to stretching to a 5- and 10-mm gap than the double-row repairs with or without the addition of a rip-stop suture (P < .05). The addition of a rip-stop stitch made the repair more resistant to gap formation than a double row repair (P < .05). The crisscross double row created by 2 medial double-loaded suture anchors and 2 lateral push-in anchors stretched more than any other group (P < .05).
Double-row repairs with either crossing sutures or 4 separate anchor points were more likely to fail (5- or 10-mm gap) than a single-row repair loaded with 3 simple sutures.
The triple-loaded anchors with ultrahigh-molecular weight polyethylene-containing sutures placed in a single row were more resistant to stretching than the double-row groups.
评估三倍和两倍加载超高分子量聚乙烯缝线的各种缝线锚钉的强度和缝线-肌腱界面安全性，并通过循环加载和破坏性测试评估将这些锚钉置于单排或双排排列中的相对效果。
使用 5 种不同修复模式中的 1 种将冈下肌重新附着到原始肱骨足迹上，共 40 个牛肩。测试了两种单排修复和三种双排修复。所有修复均使用高强度缝线。研究了 5 组：组 1，单排中 2 个三倍加载螺钉缝线锚钉，带有简单缝线；组 2，单排中 2 个三倍加载螺钉锚钉，带有穿过第四缝线的垂直缝线（“防撕裂”缝线）；组 3，2 个内侧和 2 个外侧螺钉锚钉，带有从内侧锚钉穿过的单个垂直褥式缝线和从外侧锚钉穿过的 2 个简单缝线；组 4，2 个内侧双加载螺钉锚钉系紧 2 个褥式缝线和 2 个推入式外侧锚钉，以“十字交叉”跨越缝线捕获内侧缝线；组 5，2 个内侧双加载螺钉锚钉系紧 2 个褥式缝线和 2 个推入式外侧锚钉，形成“缝线桥”缝线。标本在 1.0 Hz 下以 10 和 180 N 之间循环 3,500 次或直至失效。终点为循环加载位移（5 和 10 mm）、总位移和最终失效负载。
与没有防撕裂缝线的双排修复相比，单排中三倍加载锚钉更能抵抗拉伸至 5 和 10 mm 的间隙（P <.05）。添加防撕裂缝线使修复更能抵抗间隙形成（P <.05）。通过 2 个内侧双加载缝线锚钉和 2 个外侧推入锚钉形成的十字交叉双排拉伸超过任何其他组（P <.05）。
与单排加载 3 个简单缝线的修复相比，带有交叉缝线或 4 个单独锚点的双排修复更容易失效（5 或 10 mm 间隙）。
三倍加载带有超高分子量聚乙烯缝线的锚钉在单排中更能抵抗拉伸，而双排组则更容易失效。
