Lenz Christopher G, Wieser Karl, Lajtai Georg, Meyer Dominik C
Orthopaedic Department, Balgrist Hospital, University of Zurich, Forchstrasse 340, CH-8008, Zurich, Switzerland.
Orthopaedic Department, Private Hospital Maria Hilf, Klagenfurt, Austria.
BMC Musculoskelet Disord. 2015 Nov 17;16:357. doi: 10.1186/s12891-015-0794-9.
To compare instruments designed for arthroscopic suture handling during arthroscopic rotator cuff repair, to assess the force needed to penetrate the tendon, and to evaluate the residual defect size.
Twenty-one instruments were each tested ten times on thawed sheep infraspinatus tendons. The force needed to pierce the tendon with each instrument was measured using a custom setup. Bone wax plates were used to make the perforation marks visible and to quantify the lesions each instrument created.
The force to pierce a tendon had a range of 5.6-18.5 N/mm. Within the group of suture retrievers, the angled instruments required in average 85 % higher forces than straight instruments. The lesion area had a range of 2-7 mm(2). Suture retrievers produced significantly larger lesion sizes compared with suture shuttles.
For the identical task of passing a suture through a tendon, differences exist regarding the ease of tendon penetration and potential damage to the tendon for different tools. The design, function, and resulting lesion size may be relevant and important for surgical handling and to avoid excess structural damage to the tendon. These results suggest that choosing the most appropriate tools for arthroscopic suture stitching influences the ease of handling and final integrity of the tissue.
比较用于关节镜下肩袖修复术中关节镜缝线操作的器械，评估穿透肌腱所需的力量，并评估残余缺损大小。
对21种器械在解冻的绵羊冈下肌腱上各测试10次。使用定制装置测量每种器械穿透肌腱所需的力量。使用骨蜡板使穿孔痕迹可见，并量化每种器械造成的损伤。
穿透肌腱的力量范围为5.6 - 18.5 N/mm。在缝线取回器组中，成角器械平均所需力量比直器械高85%。损伤面积范围为2 - 7 mm²。与缝线穿梭器相比，缝线取回器产生的损伤尺寸明显更大。
对于将缝线穿过肌腱的相同任务，不同工具在肌腱穿透的难易程度和对肌腱的潜在损伤方面存在差异。设计、功能以及由此产生的损伤尺寸对于手术操作以及避免对肌腱造成过度结构损伤可能是相关且重要的。这些结果表明，选择最适合关节镜缝线缝合的工具会影响操作的难易程度和组织的最终完整性。
