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经典实心和新型全软缝线锚钉修复肩盂唇的生物力学评估。

Biomechanical evaluation of classic solid and novel all-soft suture anchors for glenoid labral repair.

机构信息

Department of Orthopaedic Surgery, University of Connecticut, Farmington, Connecticut 06034, USA.

出版信息

Arthroscopy. 2012 May;28(5):642-8. doi: 10.1016/j.arthro.2011.10.024. Epub 2012 Feb 1.

Abstract

PURPOSE

To evaluate the biomechanical performance of an all-soft suture anchor (JuggerKnot; Biomet, Warsaw, IN) in comparison with a classic solid suture anchor (2.4-mm biocomposite SutureTak; Arthrex, Naples, FL) in an in vitro labral repair model.

METHODS

We dissected 12 cadaveric shoulders (mean age, 61 ± 9.4 years), leaving the labrum intact, and bone mineral density was obtained (mean, 0.375 ± 0.06 g/cm(3)). Simulated labral tears were made at the anteroinferior and posteroinferior edges of the labrum. Repairs used 2 all-soft suture anchors (JuggerKnot) or 2 solid anchors with free, high-strength No. 2 suture (FiberWire; Arthrex) spanning the operative construct to load the repair. Differential variable reluctance transducers were used to measure labral displacement for each specimen. The testing protocol consisted of a preconditioning phase at 10 N for 10 cycles (1 Hz) and then a final load-to-failure testing at a rate of 3 mm/min. Labral displacement of 2 mm was determined as the primary outcome.

RESULTS

There was no statistical difference (P = .22) in ultimate load to failure and displacement at ultimate failure (anchor pullout) between the all-soft JuggerKnot (146.0 ± 43.0 N and 19.8 ± 5.4 mm, respectively) and the solid SutureTak (171.9 ± 52.6 N and 22.3 ± 6.8 mm, respectively). The solid anchor had a significantly higher ultimate load at 2 mm of labral displacement than the all-soft suture anchor (84.1 ± 19.0 N and 39.2 ± 10.6 N, respectively; P < .001).

CONCLUSIONS

Whereas both the solid SutureTak and the all-soft JuggerKnot displayed similar results on ultimate load-to-failure testing, the solid anchor required significantly greater load for 2 mm of labral displacement than the all-soft anchor.

CLINICAL RELEVANCE

The all-soft anchor (JuggerKnot) is similar in biomechanical performance to the classic solid anchor (SutureTak) with the exception of load at 2 mm of labral displacement, suggesting micromotion of the device.

摘要

目的

在体外肩盂唇修复模型中,评估全软缝线锚钉(JuggerKnot;Biomet,华沙,印第安纳州)与经典的实心缝线锚钉(2.4 毫米生物复合材料 SutureTak;Arthrex,那不勒斯,佛罗里达州)的生物力学性能。

方法

我们解剖了 12 具尸体肩部(平均年龄,61±9.4 岁),保留完整的肩盂唇,获取骨密度(平均值,0.375±0.06g/cm(3))。在肩盂唇的前下和后下边缘模拟肩盂唇撕裂。修复采用 2 个全软缝线锚钉(JuggerKnot)或 2 个实心锚钉,带有自由的高强度 2 号缝线(FiberWire;Arthrex)跨越手术结构,以加载修复。使用差动可变磁阻传感器测量每个标本的肩盂唇位移。测试方案包括 10N 预条件化阶段 10 个循环(1Hz),然后以 3mm/min 的速度进行最终的失效负载测试。2mm 的肩盂唇位移被确定为主要结果。

结果

全软 JuggerKnot(分别为 146.0±43.0N 和 19.8±5.4mm)和实心 SutureTak(分别为 171.9±52.6N 和 22.3±6.8mm)在最终失效载荷和最终失效时的肩盂唇位移(锚钉拔出)方面无统计学差异(P=0.22)。实心锚钉在 2mm 肩盂唇位移时的最终失效载荷明显高于全软缝线锚钉(分别为 84.1±19.0N 和 39.2±10.6N;P<0.001)。

结论

虽然实心 SutureTak 和全软 JuggerKnot 在最终失效载荷测试中表现出相似的结果,但实心锚钉在 2mm 肩盂唇位移时需要明显更大的载荷。

临床相关性

全软锚钉(JuggerKnot)与经典实心锚钉(SutureTak)在生物力学性能方面相似,除了在 2mm 肩盂唇位移时的装置微动之外。

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