Center for Musculoskeletal Surgery, Campus Virchow, Charité-Universitaetsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany.
Knee Surg Sports Traumatol Arthrosc. 2013 Jul;21(7):1647-54. doi: 10.1007/s00167-013-2510-3. Epub 2013 Apr 21.
The aim of this study was to analyse the osseous reaction after arthroscopic double-row rotator cuff repair using bio-absorbable poly-L-lactic acid (PLLA) and non-absorbable polyetheretherketone (PEEK) suture anchors. Focus of interest was the appearance of peri-implant fluid and anchor tunnel widening.
Thirty-six patients were evaluated at final follow-up (16 PLLA and 20 PEEK). Clinical results were acquired by use of the subjective shoulder value, the Constant score and the Western Ontario Rotator Cuff Index. Radiological results were analysed by supraspinatus tendon integrity, footprint coverage, muscular atrophy and fatty infiltration. Furthermore, anchor tunnel expansion was measured, anchor structure and peri-implant fluids graduated.
At 28.4 ± 8.9-month follow-up, clinical outcome was similar (n.s.). MRI investigation revealed osseous reaction in both groups; tunnel widening was 0.9 ± 0.7 mm in PLLA and 0.8 ± 0.6 mm in PEEK anchors (n.s.). Peri-implant fluid was pronounced in PLLA anchors (p < 0.05). Tunnel widening was significantly higher in lateral anchors irrespectively of the material used. Tendon integrity, muscular atrophy, fatty infiltration and footprint coverage were not significantly different (n.s.).
Both materials lead to osseous reaction in this study, whereas consequences of pronounced fluid in PLLA patients remain unclear. Pronounced tunnel widening in lateral anchors leads to the assumption that other causes such as mechanical stress potentially have to be considered when analysing osseous reaction.
III.
本研究旨在分析关节镜下双排肩袖修复中使用可吸收聚左旋乳酸（PLLA）和不可吸收聚醚醚酮（PEEK）缝线锚钉的骨反应。关注焦点是植入物周围液体和锚钉隧道增宽的表现。
36 例患者在最终随访时进行评估（16 例 PLLA 和 20 例 PEEK）。临床结果通过使用主观肩部值、Constant 评分和安大略西部肩袖指数获得。影像学结果通过分析冈上肌腱完整性、足印覆盖、肌肉萎缩和脂肪浸润进行分析。此外，还测量了锚钉隧道扩张、锚钉结构和植入物周围液体的分级。
在 28.4±8.9 个月的随访中，临床结果相似（无统计学意义）。MRI 检查显示两组均有骨反应；PLLA 锚钉隧道增宽为 0.9±0.7mm，PEEK 锚钉为 0.8±0.6mm（无统计学意义）。PLLA 锚钉周围有明显的植入物周围液体（p<0.05）。无论使用何种材料，外侧锚钉的隧道增宽均显著更高。肌腱完整性、肌肉萎缩、脂肪浸润和足印覆盖无显著差异（无统计学意义）。
在这项研究中，两种材料都导致了骨反应，而 PLLA 患者明显的液体后果尚不清楚。外侧锚钉明显的隧道增宽导致假设，在分析骨反应时，可能需要考虑其他原因，如机械应力。
III 级。
