Department of Orthopedic Surgery, Saarland University, Kirrberger Str, Homburg (Saar), Germany.
Knee Surg Sports Traumatol Arthrosc. 2012 Nov;20(11):2139-47. doi: 10.1007/s00167-012-1892-y.
Influence of the initial rotator cuff tear size and of different subregions of the SSP tendon on the cyclic loading behavior of a modified single-row reconstruction compared to a suture-bridging double-row repair.
Artificial tears (25 and 35 mm) were created in the rotator cuff of 24 human cadaver shoulders. The reconstructions were performed as a single-row repair (SR) using a modified suture configuration or a suture-bridge double-row repair (DR). Radiostereometric analysis was used under cyclic loading (50 cycles, 10–180 N, 10–250 N) to calculate cyclic displacement in three different planes (anteroposterior (x), craniocaudal (y) and mediolateral (z) level). Cyclic displacement was recorded, and differences in cyclic displacement of the anterior compared to the posterior subregions of the tendon were calculated.
In small-to-medium tears (25 mm) and medium-to-large tears (35 mm), significant lower cyclic displacement was seen for the SR-reconstruction compared to the DR-repair at 180 N (p ≤ 0.0001; p = 0.001) and 250 N (p = 0.001; p = 0.007) in the x-level. These results were confirmed in the y-level at 180 N (p = 0.001; p = 0.0022) and 250 N (p = 0.005; p = 0.0018). Comparison of the initial tear sizes demonstrated significant differences in cyclic displacement for the DR technique in the x-level at 180 N (p = 0.002) and 250 N (p = 0.004). Comparison of the anterior versus the posterior subregion of the tendon revealed significant lower gap formation in the posterior compared to the anterior subregions in the x-level for both tested rotator cuff repairs (p ≤ 0.05).
The tested single-row repair using a modified suture configuration achieved superior results in three-dimensional measurements of cyclic displacement compared to the tested double-row suture-bridge repair. The results were dependent on the initial rupture size of the rotator cuff tear. Furthermore, significant differences were found between tendon subregions of the rotator cuff with significantly higher gap formation for the anterior compared to the posterior subregions.
研究初始肩袖撕裂大小以及肩袖下滑囊肌腱不同亚区对改良单排重建与双排缝线桥接修复后周期性负载行为的影响。
在 24 个人体尸体肩的肩袖中创建 25 和 35 毫米的人工撕裂。使用改良缝线构型进行单排修复（SR）或缝线桥接双排修复（DR）。在周期性负载下（50 个循环，10-180 N，10-250 N）使用放射立体测量分析来计算三个不同平面（前后（x）、头侧尾侧（y）和内外（z）水平）中的周期性位移。记录周期性位移，并计算肌腱前亚区与后亚区之间的周期性位移差异。
在小到中等撕裂（25 毫米）和中到大撕裂（35 毫米）中，在 180 N（p ≤ 0.0001；p = 0.001）和 250 N（p = 0.001；p = 0.007）时，SR 重建的周期性位移明显低于 DR 修复，在 x 水平。在 180 N（p = 0.001；p = 0.0022）和 250 N（p = 0.005；p = 0.0018）时，y 水平也得到了相同的结果。比较初始撕裂大小，在 180 N（p = 0.002）和 250 N（p = 0.004）时，DR 技术在 x 水平的周期性位移存在显著差异。比较肌腱前亚区与后亚区，在 x 水平，两种肩袖修复的后亚区的间隙形成均明显低于前亚区（p ≤ 0.05）。
与测试的双排缝线桥接修复相比，使用改良缝线构型的测试单排修复在三维测量的周期性位移方面取得了更好的结果。结果取决于肩袖撕裂的初始破裂大小。此外，在肩袖肌腱的不同亚区之间还发现了显著差异，前亚区的间隙形成明显高于后亚区。
