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治疗髌腱断裂不同手术技术的生物力学评估

Biomechanical evaluation of different surgical techniques for treating patellar tendon ruptures.

作者信息

Schliemann Benedikt, Grüneweller Niklas, Yao Daiwei, Kösters Clemens, Lenschow Simon, Roßlenbroich Steffen B, Raschke Michael J, Weimann Andre

机构信息

Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Albert-Schweitzer-Campus 1, Building W1, 48149, Münster, Germany.

Orthopaedic Clinic of the Hanover Medical School, Annastift Hospital, Anna-von-Borries Str. 1-7, 30625, Hannover, Germany.

出版信息

Int Orthop. 2016 Aug;40(8):1717-1723. doi: 10.1007/s00264-015-3003-4. Epub 2015 Oct 3.

Abstract

PURPOSE

The aim of this study was to biomechanically assess patellar tendon repair techniques with additional cable wire or polydioxanone suture (PDS) cord augmentation in comparison with a suture-anchor repair technique.

METHODS

Patellar tendon repair was performed in 60 specimens using a porcine bone model. Yield load, maximum load, stiffness and elongation of patellar tendon reconstructions with (1) cable wire augmentation, (2) PDS cord augmentation or (3) suture anchor repair were evaluated using a cyclic loading and load-to-failure test setup.

RESULTS

In comparison with suture anchor repair, augmentation of the reconstruction with either cable wires or PDS cords provides significantly higher maximum loads (527 and 460 N vs. 301 N; p < 0.01 and p = 0,012, respectively) under load-to-failure testing and less elongation (8.81 mm ± 1.55 mm and 10.56 mm ± 3.1 mm vs. 18.38 mm ± 7.51 mm; p = 0.037 and p = 0.033, respectively) under cyclic loading conditions.

CONCLUSION

Augmentation of a patellar tendon repair with either a cable wire or a PDS cord provides higher primary stability than suture anchor repair in patellar tendon ruptures. The study supports the use of additional augmentation of a tendon repair in the clinical setting in order to prevent loss of reduction and allow for early post-operative mobilisation.

摘要

目的

本研究旨在通过生物力学方法评估在髌骨肌腱修复技术中,使用额外的缆线或聚二氧六环酮缝线(PDS)绳加强与缝线锚钉修复技术相比的效果。

方法

在60个猪骨标本上进行髌骨肌腱修复。使用循环加载和破坏载荷测试装置,评估(1)缆线加强、(2)PDS绳加强或(3)缝线锚钉修复的髌骨肌腱重建的屈服载荷、最大载荷、刚度和伸长率。

结果

在破坏载荷测试中,与缝线锚钉修复相比,使用缆线或PDS绳加强重建可提供显著更高的最大载荷(分别为527 N和460 N,对比301 N;p < 0.01和p = 0.012);在循环加载条件下伸长率更小(分别为8.81 mm ± 1.55 mm和10.56 mm ± 3.1 mm,对比18.38 mm ± 7.51 mm;p = 0.037和p = 0.033)。

结论

在髌骨肌腱断裂修复中,使用缆线或PDS绳加强比缝线锚钉修复提供更高的初始稳定性。该研究支持在临床环境中使用额外的肌腱修复加强措施,以防止复位丢失并允许早期术后活动。

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