Petri M, Dratzidis A, Brand S, Calliess T, Hurschler C, Krettek C, Jagodzinski M, Ettinger M
Trauma Department, Hannover Medical School (MHH), Carl-Neuberg-Straße 1, 30625, Hannover, Germany,
Knee Surg Sports Traumatol Arthrosc. 2015 Apr;23(4):1039-45. doi: 10.1007/s00167-014-2854-3. Epub 2014 Jan 29.
This human cadaveric study compares the biomechanical properties of quadriceps tendon repair with suture anchors and the commonly applied transosseous sutures. The hypothesis was that suture anchors provide at least equal results concerning gap formation and ultimate failure load compared with transosseous suture repair.
Thirty human cadaveric knees underwent tenotomy followed by repair with either 5.5-mm-double-loaded suture anchors [titanium (TA) vs. resorbable hydroxyapatite (HA)] or transpatellar suture tunnels using No. 2 Ultrabraid™ and the Krackow whipstitch. Biomechanical analysis included pretensioning the constructs with 20 N for 30 s and then cyclic loading of 250 cycles between 20 and 100 N at 1 Hz in a servohydraulic testing machine with measurement of elongation. Ultimate failure load analysis and failure mode analysis were performed subsequently.
Tendon repairs with suture anchors yielded significantly less gap formation during cyclic loading (20th-250th cycle: TA 1.9 ± 0.1, HA 1.5 ± 0.5, TS 33.3 ± 1.9 mm, p < 0.05) and resisted significantly higher ultimate failure loads (TA 740 ± 204 N, HA 572 ± 67 N, TS 338 ± 60 N, p < 0.05) compared with transosseous sutures. Common failure mode was pull-out of the eyelet within the suture anchor in the HA group and rupture of the suture in the TA and TS group.
Quadriceps tendon repair with suture anchors yields significantly better biomechanical results than the commonly applied transosseous sutures in this human cadaveric study. These biomechanical findings may change the future clinical treatment for quadriceps tendon ruptures. Randomised controlled clinical trials are desirable for the future.
Not applicable, controlled laboratory human cadaveric study.
本人体尸体研究比较了使用缝线锚钉与常用的经骨缝线进行股四头肌肌腱修复的生物力学特性。假设是与经骨缝线修复相比，缝线锚钉在间隙形成和极限破坏载荷方面至少能提供同等的结果。
30例人体尸体膝关节进行肌腱切断术，然后分别使用5.5毫米双负荷缝线锚钉（钛合金[TA]与可吸收羟基磷灰石[HA]）或使用2号Ultrabraid™缝线和Krackow锁边缝合法通过髌腱缝线隧道进行修复。生物力学分析包括在伺服液压试验机中用20 N对构建体预张紧30秒，然后在20至100 N之间以1 Hz进行250次循环加载，并测量伸长量。随后进行极限破坏载荷分析和破坏模式分析。
与经骨缝线相比，使用缝线锚钉进行肌腱修复在循环加载期间产生的间隙明显更小（第20至250次循环：TA为1.9±0.1，HA为1.5±0.5，经骨缝线为33.3±1.9毫米，p<0.05），并且能承受明显更高的极限破坏载荷（TA为740±204 N，HA为572±67 N，经骨缝线为338±60 N，p<0.05）。常见的破坏模式是HA组中缝线锚钉内的小孔拔出，TA组和经骨缝线组中缝线断裂。
在本人体尸体研究中，使用缝线锚钉进行股四头肌肌腱修复比常用的经骨缝线产生明显更好的生物力学结果。这些生物力学发现可能会改变未来股四头肌肌腱断裂的临床治疗方法。未来需要进行随机对照临床试验。
不适用，对照实验室人体尸体研究。
