Center for Advanced Orthopaedic Studies, Harvard Medical School, Boston, Massachusetts, USA.
Am J Sports Med. 2011 Dec;39(12):2634-9. doi: 10.1177/0363546511424723. Epub 2011 Oct 13.
All-inside meniscal repairs are performed with increasing frequency because of the availability of newly developed devices. A comparison of their biomechanical characteristics may aid physicians in selecting a method of meniscal repair.
All-inside meniscal repairs will be superior to their inside-out controls in response to cyclic loading and load-to-failure testing.
Controlled laboratory study.
Sixty-six bucket-handle tears in matched porcine menisci were repaired using the Ultra FasT-Fix, Meniscal Cinch, Ultrabraid No. 0, and FiberWire 2-0 sutures. Initial displacement, cyclic loading (100, 300, and 500 cycles), and load-to-failure testing were performed. The displacement, response to cyclic loading, and mode of failure were recorded. The stiffness was calculated.
The Meniscal Cinch demonstrated a significantly higher initial displacement than the other methods tested (P = .04). No significant difference was found among the methods in response to cyclic loading. The inside-out FiberWire repair demonstrated the highest load to failure (120.8 ± 23.5 N) and was significantly higher than both the Meniscal Cinch (64.8 ± 24.1 N, P < .001) and the Ultra FasT-Fix (88.3 ± 14.3 N, P = .002). It was not significantly higher than the inside-out Ultrabraid suture repair (98.8 ± 29.2 N). The inside-out FiberWire repair had the highest stiffness (28.7 ± 7.8 N/mm). It was significantly higher than the Meniscal Cinch (18.0 ± 8.8 N/mm, P = .01). The most common mode of failure in all methods was suture failure.
An inside-out suture repair affords surgeons the best overall biomechanical characteristics of the devices tested (initial displacement, response to cyclic loading, and load to failure). For an all-inside repair, the Ultra FasT-Fix reproduces the characteristics of its matched inside-out suture repair more closely than the Meniscal Cinch.
Inside-out sutures and all-inside devices have similar responses to cyclic loading.
由于新型设备的出现，全内视半月板修复术的应用日益增多。比较其生物力学特性可以帮助医生选择半月板修复方法。
全内视半月板修复术在应对循环加载和失效测试时将优于其对应的内视修复。
对照实验室研究。
在匹配的猪半月板上用 Ultra FasT-Fix、Meniscal Cinch、Ultrabraid No.0 和 FiberWire 2-0 缝线修复 66 例桶柄状撕裂。进行初始位移、循环加载（100、300 和 500 次）和失效测试。记录位移、循环加载反应和失效模式。计算刚度。
Meniscal Cinch 的初始位移明显高于其他测试方法（P=0.04）。在循环加载反应方面，各种方法之间没有显著差异。内视 FiberWire 修复的失效负载最高（120.8±23.5 N），明显高于 Meniscal Cinch（64.8±24.1 N，P<.001）和 Ultra FasT-Fix（88.3±14.3 N，P=0.002）。与内视 Ultrabraid 缝线修复（98.8±29.2 N）相比差异无统计学意义。内视 FiberWire 修复的刚度最高（28.7±7.8 N/mm）。明显高于 Meniscal Cinch（18.0±8.8 N/mm，P=0.01）。所有方法中最常见的失效模式是缝线失效。
内视缝线修复为外科医生提供了测试器械中最佳的整体生物力学特性（初始位移、循环加载反应和失效负载）。对于全内视修复，Ultra FasT-Fix 比 Meniscal Cinch 更接近其对应的内视缝线修复。
内视缝线和全内视器械对循环加载的反应相似。
