Dwyer Tim, Willett Thomas L, Dold Andrew P, Petrera Massimo, Wasserstein David, Whelan Danny B, Theodoropoulos John S
Women's College, Toronto Western Hospital, University of Toronto Orthopaedic Sports Medicine, 76 Grenville St, Toronto, ON, M5S 1B1, Canada.
Musculoskeletal Research Laboratory, Division of Orthopaedic Surgery, Samuel Lunenfeld Research Institute, Mount Sinai Hospital, 25 Orde Street, Room 416, Toronto, ON, M5T 3H7, Canada.
Knee Surg Sports Traumatol Arthrosc. 2016 Feb;24(2):357-64. doi: 10.1007/s00167-013-2760-0. Epub 2013 Nov 8.
The purpose of this study was to evaluate the biomechanical behavior of an all-suture glenoid anchor in comparison with a more conventional screw-in glenoid anchor, with regard to maximum load to failure and tensile displacement.
All mechanical testing was performed using an Instron ElectroPuls E1000 mechanical machine, with a 10 N pre-load and displacement rate of 10 mm/min. Force-displacement curves were generated, with calculation of maximum load, maximum displacement, displacement at 50 N and stiffness. Pretesting of handset Y-Knots in bone analog models revealed low force displacement below 60 N of force. Subsequently, three groups of anchors were tested for pull out strength in bovine bone and cadaver glenoid bone: a bioabsorbable screw-in anchor (Bio Mini-Revo, ConMed Linvatec), a handset all-suture anchor (Y-Knot, ConMed Linvatec) and a 60 N pre-tensioned all-suture anchor (Y-Knot). A total of 8 anchors from each group was tested in proximal tibia of bovine bone and human glenoids (age range 50-90).
In bovine bone, the Bio Mini-Revo displayed greater maximum load to failure (206 ± 77 N) than both the handset (140 ± 51 N; P = 0.01) and the pre-tensioned Y-Knot (135 ± 46 N; P = 0.001); no significant difference was seen between the three anchor groups in glenoid bone. Compared to the screw-in anchors, the handset all-suture anchor displayed inferior fixation, early displacement and greater laxity in the bovine bone and cadaveric bone (P < 0.05). Pre-tensioning the all-suture anchor to 60 N eliminated this behavior in all bone models.
Handset Y-Knots display low force anchor displacement, which is likely due to slippage in the pilot hole. Pre-tensioning the Y-Knot to 60 N eliminates this behavior.
I.
本研究旨在评估全缝线型肩胛盂锚钉与更传统的拧入式肩胛盂锚钉相比，在最大破坏载荷和拉伸位移方面的生物力学行为。
所有力学测试均使用英斯特朗ElectroPuls E1000力学试验机进行，预加载荷为10 N，位移速率为10 mm/min。生成力-位移曲线，并计算最大载荷、最大位移、50 N时的位移和刚度。在骨模拟模型中对手持式Y形结进行预测试，结果显示在60 N以下的力时力位移较低。随后，对三组锚钉在牛骨和尸体肩胛盂骨中进行拔出强度测试：一种可生物吸收的拧入式锚钉（Bio Mini-Revo，康美医疗林瓦特克公司）、一种手持式全缝线锚钉（Y形结，康美医疗林瓦特克公司）和一种60 N预张紧的全缝线锚钉（Y形结）。每组共8个锚钉在牛骨近端胫骨和人肩胛盂（年龄范围50-90岁）中进行测试。
在牛骨中，Bio Mini-Revo显示出比手持式锚钉（140±51 N；P = 0.01）和预张紧的Y形结（135±46 N；P = 0.001）更大的最大破坏载荷；在肩胛盂骨中，三组锚钉之间未观察到显著差异。与拧入式锚钉相比，手持式全缝线锚钉在牛骨和尸体骨中显示出较差的固定、早期位移和更大的松弛度（P < 0.05）。将全缝线锚钉预张紧至60 N可消除所有骨模型中的这种行为。
手持式Y形结显示出低力锚钉位移，这可能是由于导向孔中的滑动所致。将Y形结预张紧至60 N可消除这种行为。
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