Ma Ching-Hou, Lin Ting-Sheng, Wu Chin-Hsien, Li Dong-Yi, Yang Shih-Chieh, Tu Yuan-Kun
Department of Orthopedics, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan.
Department of Biomedical Engineering, I-Shou University, Kaohsiung, Taiwan.
Arthroscopy. 2017 Feb;33(2):297-304. doi: 10.1016/j.arthro.2016.10.027. Epub 2016 Dec 27.
To biomechanically compare the stability between open repair and arthroscopic transosseous repair technique for reattachment of the foveal triangular fibrocartilage complex (TFCC). We also evaluated the feasibility of a new aiming device for the creation of 2 bone tunnels simultaneously during the arthroscopic technique.
Six matched pairs of fresh-frozen forearm cadaver specimens were prepared for testing. Group I specimens were treated by open repair with suture anchor. Group II specimens were treated by arthroscopic transosseous suture with a new aiming device. Before and after disruption of the TFCC fovea and after its repair, dorsal and palmar translation of the ulna was measured in both groups in response to a load (3 kg) applied in the palmar and then in the dorsal direction. The total translation of the ulna was calculated as the sum of the mean dorsal and palmar translations.
The mean total ulnar translation before and after TFCC disruption, and after TFCC repair was 5.94 ± 2.16 mm, 9.08 ± 2.64 mm, and 6.04 ± 2.18 mm, respectively. The specimens demonstrated a significant increase in the total translation of the ulna after disruption of the ulnar attachment of TFCC (P = .003), whereas a significant decrease was observed after TFCC foveal repair (P = .003). The median percentage of eliminated translation after TFCC repair was 64% and 172%, respectively, in groups I and II (P = .043).
The athroscopic transosseous suture technique demonstrated superior repair efficacy to the open repair technique in terms of biomechanical strength. This cadaveric study also demonstrated the feasibility of a new aiming device.
When making decisions about TFCC foveal repair, arthroscopic transosseous suture technique may provide better biomechanical strength than the open repair technique.
通过生物力学比较开放性修复与关节镜下经骨修复技术在修复中央凹三角纤维软骨复合体（TFCC）时的稳定性。我们还评估了一种新型瞄准装置在关节镜技术中同时创建两个骨隧道的可行性。
准备六对匹配的新鲜冷冻前臂尸体标本用于测试。第一组标本采用缝线锚钉进行开放性修复。第二组标本采用新型瞄准装置进行关节镜下经骨缝合。在TFCC中央凹破坏前后及其修复后，对两组施加掌侧然后背侧的负荷（3千克），测量尺骨的背侧和掌侧移位。尺骨的总移位计算为背侧和掌侧平均移位之和。
TFCC破坏前后以及TFCC修复后的尺骨平均总移位分别为5.94±2.16毫米、9.08±2.64毫米和6.04±2.18毫米。标本在TFCC尺侧附着破坏后尺骨总移位显著增加（P = 0.003），而在TFCC中央凹修复后观察到显著减少（P = 0.003）。TFCC修复后移位消除的中位数百分比在第一组和第二组中分别为64%和172%（P = 0.043）。
就生物力学强度而言，关节镜下经骨缝合技术显示出比开放性修复技术更优的修复效果。这项尸体研究还证明了新型瞄准装置的可行性。
在决定TFCC中央凹修复时，关节镜下经骨缝合技术可能比开放性修复技术提供更好的生物力学强度。
