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经皮骨隧道缝线固定与缝线锚钉固定肌腱止点在不同愈合阶段的生物力学比较:兔腱止点愈合模型的实验研究

Biomechanical evaluation on tendon reinsertion by comparing trans-osseous suture and suture anchor at different stages of healing: experimental study on rabbits.

机构信息

Santa Casa de Misericórdia da Bahia, Hospital Santa Izabel and Escola Baiana de Medicina e Saúde Pública, Salvador, Bahia, Brazil.

出版信息

J Shoulder Elbow Surg. 2010 Sep;19(6):878-83. doi: 10.1016/j.jse.2010.03.008. Epub 2010 Jun 15.

Abstract

BACKGROUND

Through an experimental biomechanical study on rabbits, tendon reinsertion by means of trans-osseous suture on a spongy bone bed and suture anchor were evaluated comparatively at different phases of healing.

METHODS

Twenty-four New Zealand White rabbits were used: 2 as pilots, 4 as the control group, and 18 as the experimental group. These 18 animals underwent sectioning and reinsertion of the Achilles tendon bilaterally, using the technique of trans-osseous suture on 1 side and suture anchor on the other. All the pelvic limbs that underwent the procedure were then immobilized for 3 weeks. The experimental group was divided into 3 groups that were sacrificed, respectively, 3, 6, and 12 weeks later. The tendon-bone complex was subjected to biomechanical tests to evaluate the parameters of maximum strength, stiffness, and yield strength.

RESULTS

There was no statistically significant difference between the suture anchor group and the trans-osseous suture group, in relation to yield strength (3 weeks, P = .222; 6 weeks, P = .465; and 12 weeks, P = .200) or maximum strength (3 weeks, P = .222; 6 weeks, P = .076; and 12 weeks, P = .078). In relation to stiffness, the suture anchor group showed a statistically significant difference only at 3 weeks of healing (P = .032) over the trans-osseous suture group.

CONCLUSION

The technique of suturing with an anchor was shown to be similar to the technique of trans-osseous suture for the studied parameters.

摘要

背景

通过对兔子的实验生物力学研究,比较了在不同愈合阶段在海绵骨床上进行经骨缝合的肌腱再附着和缝合锚的效果。

方法

使用 24 只新西兰白兔:2 只为试验组,4 只为对照组,18 只为实验组。这 18 只动物双侧进行跟腱切断和再附着,一侧采用经骨缝合技术,另一侧采用缝合锚技术。所有接受手术的骨盆肢体均固定 3 周。实验组分为 3 组,分别在术后 3、6 和 12 周处死。对肌腱-骨复合体进行生物力学测试,以评估最大强度、刚度和屈服强度等参数。

结果

在屈服强度方面,缝合锚组与经骨缝合组之间无统计学差异(3 周,P =.222;6 周,P =.465;12 周,P =.200)或最大强度(3 周,P =.222;6 周,P =.076;12 周,P =.078)。在刚度方面,缝合锚组仅在愈合 3 周时与经骨缝合组有统计学差异(P =.032)。

结论

就研究参数而言,缝合锚技术与经骨缝合技术相似。

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