Röpke Ekkehard F, Kopf Sebastian, Drange Steffen, Becker Roland, Lohmann Christoph H, Stärke Christian
Department of Orthopedic Surgery, Otto-von-Guericke-University of Magdeburg, Leipziger Straße 44, 39120, Magdeburg, Germany.
Knee Surg Sports Traumatol Arthrosc. 2015 Jan;23(1):45-50. doi: 10.1007/s00167-013-2589-6. Epub 2013 Jul 16.
Meniscal root repair is commonly practised using transtibial pull-out sutures. The purpose of the study was to investigate whether these are effective in restoring contact of the root to its footprint and a normal loading pattern of the cartilage under restricted loading conditions as used post-operatively.
First, a transtibial pull-out suture was simulated using porcine menisci (n = 10). It was repetitively loaded (100×; 1-10 N) and the elongation of the suture determined. In the second part of the study, porcine knees (n = 8) were subjected to repetitive low-level femoro-tibial loads (50 cycles; 100 N). A displacement sensor measured the deformation of the cartilage in the area of femoro-tibial contact. The residual deformation of the cartilage, which results from its viscoelastic behaviour, was determined as a measure of the local stress. Three scenarios were investigated: meniscal root intact, detached, and repaired.
Repetitive loading caused a median suture elongation of 3.8 mm. Residual deformation of the cartilage was increased (p = 0.047) with the root detached. Root repair could not restore it to normal (n.s.).
In this model, meniscus root repair was not effective in restoring the normal loading pattern of the cartilage because cyclic loading caused an elongation of the repair.
In practice, this effect might impair the healing of repaired meniscal roots to the tibial bone.
半月板根部修复通常采用经胫骨拉出缝线的方法。本研究的目的是调查在术后使用的受限负荷条件下，这些缝线在恢复根部与附着点的接触以及软骨的正常负荷模式方面是否有效。
首先，使用猪半月板（n = 10）模拟经胫骨拉出缝线。对其进行重复加载（100次；1 - 10 N）并测定缝线的伸长情况。在研究的第二部分，对猪膝关节（n = 8）施加重复的低水平股骨 - 胫骨负荷（50个循环；100 N）。位移传感器测量股骨 - 胫骨接触区域软骨的变形。将由软骨粘弹性行为导致的软骨残余变形作为局部应力的度量来确定。研究了三种情况：半月板根部完整、分离和修复。
重复加载导致缝线中位伸长3.8 mm。根部分离时软骨的残余变形增加（p = 0.047）。根部修复未能使其恢复正常（无统计学意义）。
在该模型中，半月板根部修复在恢复软骨正常负荷模式方面无效，因为循环加载导致修复处伸长。
在实际中，这种效应可能会损害修复的半月板根部与胫骨的愈合。
