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生物可吸收增强材料可提高用于肩袖修复的锚钉的拔出稳定性:一项尸体研究。

Pull-out stability of anchors for rotator cuff repair is also increased by bio-absorbable augmentation: a cadaver study.

作者信息

Postl L K, Ahrens P, Beirer M, Crönlein M, Imhoff A B, Foehr P, Burgkart R, Braun C, Kirchhoff Chlodwig

机构信息

Department of Trauma Surgery, Klinikum rechts der Isar, Technische Universitaet Muenchen, Ismaninger Str. 22, 81675, Munich, Germany.

Department of Orthopedics and Sportorthopedics, Klinikum rechts der Isar, Technische Universitaet Muenchen, Ismaninger Str. 22, 81675, Munich, Germany.

出版信息

Arch Orthop Trauma Surg. 2016 Aug;136(8):1153-8. doi: 10.1007/s00402-016-2484-y. Epub 2016 Jun 11.

Abstract

INTRODUCTION

Osteoporosis is a highly focused issue in current scientific research and clinical treatment. Especially in rotator cuff repair, the low bone quality of patients suffering from osteoporosis is an important issue. In this context, non-biological solutions using PMMA for anchor augmentation have been developed in the recent past. The aim of this study was to evaluate whether augmentation of suture anchors using bio-absorbable osteoconductive fiber-reinforced calcium phosphate results in improved failure load of suture anchors as well.

MATERIALS AND METHODS

Altogether 24 suture anchors (Corkscrew FT 1 Suture Anchors, Arthrex, Naples, FL, USA) were evaluated by applying traction until pullout in 12 paired fresh frozen human cadaver humeri using a servo-hydraulic testing machine. Inclusion criteria were an age of more than 64 years, a macroscopically intact RC and an intact bone. The anchors were evaluated at the anterolateral and posteromedial aspect of the greater tuberosity. 12 suture anchors were augmented and 12 suture anchors were conventionally inserted.

RESULTS

The failure load was significantly enhanced by 66.8 % by the augmentation method. The fiber-reinforced calcium phosphate could be easily injected and applied.

CONCLUSION

The bio-absorbable cement in this study could be a promising augmentation material for RC reconstructions, but further research is necessary-the material has to be evaluated in vivo.

摘要

引言

骨质疏松症是当前科研和临床治疗中备受关注的问题。特别是在肩袖修复中,骨质疏松患者的低骨质量是一个重要问题。在此背景下,近年来已开发出使用聚甲基丙烯酸甲酯(PMMA)进行锚钉增强的非生物解决方案。本研究的目的是评估使用生物可吸收骨传导纤维增强磷酸钙对缝合锚钉进行增强是否也能提高缝合锚钉的失效载荷。

材料与方法

使用伺服液压试验机对12对新鲜冷冻的人体尸体肱骨进行牵引直至拔出,共评估24个缝合锚钉(螺旋FT 1缝合锚钉,美国佛罗里达州那不勒斯市的Arthrex公司)。纳入标准为年龄超过64岁、宏观上肩袖完整且骨骼完整。在大结节的前外侧和后内侧对锚钉进行评估。12个缝合锚钉进行了增强处理,12个缝合锚钉采用传统方式植入。

结果

通过增强方法,失效载荷显著提高了66.8%。纤维增强磷酸钙易于注射和应用。

结论

本研究中的生物可吸收骨水泥可能是用于肩袖重建的一种有前景的增强材料,但还需要进一步研究——该材料必须在体内进行评估。

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