Congress Medical Foundation, Pasadena, California, USA.
Am J Sports Med. 2012 Apr;40(4):875-81. doi: 10.1177/0363546511433407. Epub 2012 Feb 1.
Both simple and mattress repair techniques have been utilized with success for type II superior labral anterior-posterior (SLAP) lesions; however, direct anatomic and biomechanical comparisons of these techniques have yet to be clearly demonstrated.
For type II SLAP lesions, the mattress suture repair technique will result in greater labral height and better position on the glenoid face and exhibit stronger biomechanical characteristics, when cyclically loaded and loaded to failure through the biceps, compared with the simple suture repair technique.
Controlled laboratory study.
Six matched pairs of cadaveric shoulders were dissected, and a clock face was created on the glenoid from 9 o'clock (posterior) to 3 o'clock (anterior). For the intact specimen, labral height and labral distance from the glenoid edge were measured using a MicroScribe. A SLAP lesion was then created from 10 o'clock to 2 o'clock. Lesions were repaired with two 3.0-mm BioSuture-Tak anchors placed at 11 o'clock and 1 o'clock. For each pair, a mattress repair was used for one shoulder, and a simple repair was used for the contralateral shoulder. After repair, labral height and labral distance from the glenoid edge were again measured. The specimens were then cyclically loaded and loaded to failure through the biceps using an Instron machine. A paired t test was used for statistical analysis.
After mattress repair, a significant increase in labral height occurred compared with intact from 2.5 ± 0.3 mm to 4.3 ± 0.3 mm at 11 o'clock (P = .013), 2.7 ± 0.5 mm to 4.2 ± 0.7 mm at 12:30 o'clock (P = .007), 3.1 ± 0.5 mm to 4.2 ± 0.7 mm at 1 o'clock (P = .006), and 2.8 ± 0.7 mm to 3.7 ± 0.8 mm at 1:30 o'clock (P = .037). There was no significant difference in labral height between the intact condition and after simple repair at any clock face position. Labral height was significantly increased in the mattress repairs compared with simple repairs at 11 o'clock (mean difference, 2.0 mm; P = .008) and 12:30 o'clock (mean difference, 1.3 mm; P = .044). Labral distance from the glenoid edge was not significantly different between techniques. No difference was observed between the mattress and simple repair techniques for all biomechanical parameters, except the simple technique had a higher load and energy absorbed at 2-mm displacement.
The mattress technique created a greater labral height while maintaining similar biomechanical characteristics compared with the simple repair, with the exception of load and energy absorbed at 2-mm displacement, which was increased for the simple technique.
Mattress repair for type II SLAP lesions creates a higher labral bumper compared with simple repairs, while both techniques resulted in similar biomechanical characteristics.
对于 II 型上盂唇前后向（SLAP）损伤，已经成功地使用了简单和褥式修复技术；然而，这些技术的直接解剖学和生物力学比较尚未得到明确证明。
对于 II 型 SLAP 病变，与简单缝线修复技术相比，褥式缝线修复技术在循环加载和肱二头肌加载至失效时，将在盂唇高度和盂唇在关节窝表面的位置上产生更大的改善，并表现出更强的生物力学特性。
对照实验室研究。
对 6 对配对的尸体肩部进行解剖，在关节窝上从 9 点（后部）到 3 点（前部）创建钟面。对于完整标本，使用 MicroScribe 测量盂唇高度和盂唇距关节窝边缘的距离。然后在 10 点至 2 点之间创建 SLAP 病变。使用两个 3.0-mm 的 BioSuture-Tak 锚钉在 11 点和 1 点修复病变。对于每一对，一只肩膀使用褥式修复，另一只肩膀使用简单修复。修复后，再次使用 MicroScribe 测量盂唇高度和盂唇距关节窝边缘的距离。然后使用 InStron 机器对标本进行循环加载和肱二头肌加载至失效。使用配对 t 检验进行统计分析。
与完整标本相比，褥式修复后，盂唇高度在 11 点显著增加，从 2.5±0.3mm 增加到 4.3±0.3mm（P=0.013），在 12：30 点从 2.7±0.5mm 增加到 4.2±0.7mm（P=0.007），在 1 点从 3.1±0.5mm 增加到 4.2±0.7mm（P=0.006），在 1：30 点从 2.8±0.7mm 增加到 3.7±0.8mm（P=0.037）。在任何钟面位置，盂唇高度在完整标本与简单修复之间均无显著差异。与简单修复相比，褥式修复在 11 点（平均差异 2.0mm；P=0.008）和 12：30 点（平均差异 1.3mm；P=0.044）时盂唇高度显著增加。盂唇距关节窝边缘的距离在两种技术之间无显著差异。除了 2mm 位移时简单修复的负荷和吸收能量更高外，褥式和简单修复技术在所有生物力学参数方面均无差异。
与简单修复相比，褥式修复技术可增加盂唇高度，同时保持相似的生物力学特性，但 2mm 位移时的负荷和吸收能量除外，简单修复的这两个参数更高。
对于 II 型 SLAP 病变，褥式修复技术可产生比简单修复更高的盂唇凸度，同时两种技术均产生相似的生物力学特性。
