Hapa Onur, Barber F Alan, Başçı Onur, Horoz Levent, Ertem Fatih, Karakaşlı Ahmet, Havitçioğlu Hasan
Department of Orthopedic Surgery, Dokuz Eylül University, İzmir, Turkey.
Plano Orthopedic & Sports Medicine Center, Plano, Texas, U.S.A.
Arthroscopy. 2016 Jun;32(6):1010-6. doi: 10.1016/j.arthro.2015.12.044. Epub 2016 Mar 2.
To determine the strength of various suture techniques and the impact of suture passer size on cyclically loaded hip labra.
We assigned 63 bovine hip labra to 9 simple knotless suture technique groups using OrthoCord suture: (1) penetrating grasper (2.6 mm)-placed horizontal mattress, (2) penetrating grasper-placed vertical mattress, (3) SutureLasso (1.8 mm)-placed vertical mattress, (4) penetrating grasper-placed oblique repair, (5) penetrating grasper-placed vertical mattress plus radiofrequency, (6) SutureLasso-placed horizontal mattress, (7) SutureLasso-placed oblique mattress, (8) SutureLasso-placed horizontal mattress plus radiofrequency, and (9) SutureLasso-placed oblique mattress plus radiofrequency. After 20 cycles of uniaxial tensile loading (5 to 80 N), destructive testing was performed.
Penetrating grasper-placed horizontal mattress sutures showed lower ultimate failure loads than vertical and oblique mattress sutures (P < .05). Penetrating grasper-placed vertical mattress sutures had higher peak-to-peak displacement than SutureLasso-placed vertical mattress sutures (P = .04). SutureLasso-placed oblique mattress sutures had a higher ultimate load (P < .01) and stiffness (P = .04) than SutureLasso-placed horizontal mattress sutures. SutureLasso-placed horizontal mattress sutures had lower cyclic elongation than penetrating grasper-placed horizontal mattress sutures (P = .01) and lower ultimate load (P < .01) and stiffness than SutureLasso-placed vertical mattress sutures (P < .01). Horizontal mattress sutures with radiofrequency had a higher ultimate load (P = .02), stiffness, and cyclic elongation (P < .01) than without radiofrequency.
A horizontal mattress hip labrum stitch shows a lower ultimate failure load than vertical or oblique mattress stitches. Smaller-diameter suture-passing devices show less cyclic displacement and elongation than larger-diameter devices. Radiofrequency labral treatment does not alter vertical stitch strength but does alter horizontal mattress stitch strength.
Vertical and oblique stitches are stronger than horizontal stitches. A 1.8-mm passing device shows a better cyclic loading performance than a 2.6-mm device.
确定各种缝合技术的强度以及缝合器尺寸对周期性加载的髋关节盂唇的影响。
我们使用OrthoCord缝线将63个牛髋关节盂唇分配到9个简单无结缝合技术组：（1）穿刺抓持器（2.6毫米）放置的水平褥式缝合，（2）穿刺抓持器放置的垂直褥式缝合，（3）SutureLasso（1.8毫米）放置的垂直褥式缝合，（4）穿刺抓持器放置的斜向修复，（5）穿刺抓持器放置的垂直褥式缝合加射频，（6）SutureLasso放置的水平褥式缝合，（7）SutureLasso放置的斜向褥式缝合，（8）SutureLasso放置的水平褥式缝合加射频，以及（9）SutureLasso放置的斜向褥式缝合加射频。在进行20个周期的单轴拉伸加载（5至80牛）后，进行破坏性测试。
穿刺抓持器放置的水平褥式缝合显示出比垂直和斜向褥式缝合更低的极限破坏载荷（P <.05）。穿刺抓持器放置的垂直褥式缝合比SutureLasso放置的垂直褥式缝合具有更高的峰峰值位移（P =.04）。SutureLasso放置的斜向褥式缝合比SutureLasso放置的水平褥式缝合具有更高的极限载荷（P <.01）和刚度（P =.04）。SutureLasso放置的水平褥式缝合比穿刺抓持器放置的水平褥式缝合具有更低的循环伸长率（P =.01），并且比SutureLasso放置的垂直褥式缝合具有更低的极限载荷（P <.01）和刚度（P <.01）。带射频的水平褥式缝合比不带射频的具有更高的极限载荷（P =.02）、刚度和循环伸长率（P <.01）。
水平褥式髋关节盂唇缝合显示出比垂直或斜向褥式缝合更低的极限破坏载荷。较小直径的缝合器在循环位移和伸长方面比大直径的更小。射频盂唇治疗不会改变垂直缝合的强度，但会改变水平褥式缝合的强度。
垂直和斜向缝合比水平缝合更强。1.8毫米的缝合器在循环加载性能方面比2.6毫米的更好。
