Orthopaedic Research Institute, St. George Hospital Campus, University of New South Wales, Sydney, Australia.
Arthroscopy. 2010 Jul;26(7):877-84. doi: 10.1016/j.arthro.2010.04.007.
The purpose of this study was to determine whether transtendon repair by use of a novel small-diameter knotless anchor showed enhanced mechanical properties compared with tear completion and repair.
Articular-sided partial-thickness tears were created ex vivo in the infraspinatus of 24 ovine shoulders. The specimens were randomized into 4 groups of 6 each: (1) no repair, (2) transtendon repair, (3) completion of tear with tension-band single-row repair, and (4) completion of tear with double-row repair. Footprint contact pressure and ultimate load to failure were measured in each specimen.
Technical failure of the transtendon anchors occurred in 3 of 15 shoulders. Transtendon repair (mean +/- SEM, 0.8 +/- 0.1 MPa) and double-row repair (1 +/- 0.09 MPa) showed 3-fold (P < .001) greater footprint contact pressures than tension-band single-row repair (0.3 +/- 0.03 MPa) and no repair (0.3 +/- 0.02 MPa). The ultimate load to failure for transtendon repair (544 +/- 22 N) was more than 3 times greater than that for the double-row repair (157 +/- 23 N) (P < .001) and the single-row repair (116 +/- 11 N) (P < .001).
Transtendon repair of partial-thickness tears by use of specifically designed anchors biomechanically outperformed tear completion and repair in an ovine model. Transtendon repair showed the best combination of high footprint contact pressure and high ultimate failure load. However, the high insertion failure rate of these transtendon anchors is of concern.
On the basis of the biomechanical data, transtendon repair of partial-thickness rotator cuff tears may be used as an alternative to tear completion and repair, but the specific transtendon anchors used in this study need further evaluation before their clinical use can be recommended.
本研究旨在确定使用新型小直径无结锚钉进行腱内修复是否比撕裂完成和修复具有更高的力学性能。
在 24 个羊肩的关节侧部分厚度撕裂中创建了离体部分厚度撕裂。将标本随机分为 4 组，每组 6 个：（1）无修复，（2）腱内修复，（3）张力带单排修复完成撕裂，（4）双排修复完成撕裂。在每个标本中测量了足迹接触压力和最终失效载荷。
15 个肩中的 3 个出现了腱内锚钉的技术故障。腱内修复（平均值 +/- SEM，0.8 +/- 0.1 MPa）和双排修复（1 +/- 0.09 MPa）的足迹接触压力比张力带单排修复（0.3 +/- 0.03 MPa）和无修复（0.3 +/- 0.02 MPa）高 3 倍（P <.001）。腱内修复的最终失效载荷（544 +/- 22 N）是双排修复（157 +/- 23 N）（P <.001）和单排修复（116 +/- 11 N）（P <.001）的 3 倍以上。
在羊模型中，使用专门设计的锚钉进行部分厚度撕裂的腱内修复在生物力学上优于撕裂完成和修复。腱内修复显示出高足迹接触压力和高最终失效载荷的最佳组合。然而，这些腱内锚钉的高插入失效率令人关注。
根据生物力学数据，部分厚度肩袖撕裂的腱内修复可以作为撕裂完成和修复的替代方法，但在推荐临床应用之前，需要进一步评估本研究中使用的特定腱内锚钉。
