Department of Orthopaedic Surgery, University of Missouri, Columbia, MO, USA; Comparative Orthopaedic Laboratory, University of Missouri, Columbia, MO, USA; Department of Bioengineering, University of Missouri, Columbia, MO, USA.
Department of Orthopaedic Surgery, University of Missouri, Columbia, MO, USA.
J Shoulder Elbow Surg. 2014 Aug;23(8):1156-61. doi: 10.1016/j.jse.2013.12.036. Epub 2014 Apr 13.
This study examined histologic characteristics and biomechanical performance of 2 commercially available, small glenoid anchors.
Adult research dogs (n = 6) were used for histologic analysis. Anchors were inserted into the lateral rim of the glenoid using the manufacturer's protocol. The dogs were humanely euthanatized 8 weeks after anchor implantation, and the glenoids were collected for histologic analysis. Bone socket width data were compared for statistically significant (P < .05) differences. In addition, 4 matched pairs (n = 8) of human cadaveric glenoids were instrumented with 1 BioComposite SutureTak (Arthrex, Naples, FL, USA) and 1 JuggerKnot (Biomet, Warsaw, IN, USA) suture anchor in the anterior-inferior quadrant. Anchor constructs were preloaded to 5 N, cycled from 5 to 25 N for 100 cycles, and then pulled to failure.
All JuggerKnot anchor sites were cyst-like cavities with a rim of dense lamellar bone. All BioComposite SutureTak anchor sites contained intact anchors with close approximation of anastomosing trabeculae of lamellar bone. At 8 weeks after implantation, mean socket width of the JuggerKnot anchor sites was 6.3 ± 2.5 mm, which was significantly (P = .013) larger than the mean socket width of 2.7 ± 0.7 mm measured for the BioComposite SutureTak anchor sites. The JuggerKnot anchor demonstrated larger displacements during subfailure cyclic loading (2.9 ± 1.0 mm compared with 1.3 ± 0.4 mm) and load to failure tests (13.7 ± 6.6 mm compared with 3.2 ± 0.5 mm). Statistical differences (P < .01) existed in every category except ultimate load.
Based on the biomechanical in human bone and histologic findings in canine subjects, the all-suture anchor may be at risk for clinical failure.
本研究检查了两种市售小型肩盂锚钉的组织学特征和生物力学性能。
使用成年研究犬(n = 6)进行组织学分析。使用制造商的方案将锚钉插入肩盂的外侧边缘。在植入锚钉 8 周后,犬被人道安乐死,收集肩盂进行组织学分析。比较骨窝宽度数据,以确定统计学上的显著差异(P <.05)。此外,4 对(n = 8)匹配的人尸骸肩盂在前下象限中分别使用 1 个 BioComposite SutureTak(Arthrex,Naples,FL,USA)和 1 个 JuggerKnot(Biomet,Warsaw,IN,USA)缝线锚钉进行了仪器化。将锚钉构建体预加载至 5 N,从 5 到 25 N 循环 100 次,然后拉至失效。
所有 JuggerKnot 锚钉部位均为囊性腔隙,边缘有致密的板层骨。所有 BioComposite SutureTak 锚钉部位均包含完整的锚钉,板层骨吻合的小梁紧密接近。植入后 8 周,JuggerKnot 锚钉部位的平均窝宽度为 6.3 ± 2.5 mm,明显大于 BioComposite SutureTak 锚钉部位的平均窝宽度 2.7 ± 0.7 mm(P =.013)。在亚失效循环加载过程中,JuggerKnot 锚钉的位移更大(2.9 ± 1.0 mm 比 1.3 ± 0.4 mm),在失效测试中也更大(13.7 ± 6.6 mm 比 3.2 ± 0.5 mm)。除最终负载外,每个类别都存在统计学差异(P <.01)。
基于人体骨的生物力学和犬科动物的组织学发现,全缝线锚钉可能存在临床失败的风险。