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单排十字缝合法肩袖修补术中的负荷反应与间隙形成

Load response and gap formation in a single-row cruciate suture rotator cuff repair.

作者信息

Huntington Lachlan, Richardson Martin, Sobol Tony, Caldow Jonathon, Ackland David C

机构信息

Department of Mechanical Engineering, The University of Melbourne, Melbourne, Victoria, Australia.

Department of Orthopaedic Surgery, Epworth Healthcare, Richmond, Victoria, Australia.

出版信息

ANZ J Surg. 2017 Jun;87(6):483-487. doi: 10.1111/ans.13875. Epub 2017 Jan 26.

Abstract

BACKGROUND

Double-row rotator cuff tendon repair techniques may provide superior contact area and strength compared with single-row repairs, but are associated with higher material expenses and prolonged operating time. The purpose of this study was to evaluate gap formation, ultimate tensile strength and stiffness of a single-row cruciate suture rotator cuff repair construct, and to compare these results with those of the Mason-Allen and SutureBridge repair constructs.

METHODS

Infraspinatus tendons from 24 spring lamb shoulders were harvested and allocated to cruciate suture, Mason-Allen and SutureBridge repair groups. Specimens were loaded cyclically between 10 and 62 N for 200 cycles, and gap formation simultaneously measured using a high-speed digital camera. Specimens were then loaded in uniaxial tension to failure, and construct stiffness and repair strength were evaluated.

RESULTS

Gap formation in the cruciate suture repair was significantly lower than that of the Mason-Allen repair (mean difference = 0.6 mm, P = 0.009) and no different from that of the SutureBridge repair (P > 0.05). Both the cruciate suture repair (mean difference = 15.7 N/mm, P = 0.002) and SutureBridge repair (mean difference = 15.8 N/mm, P = 0.034) were significantly stiffer than that of the Mason-Allen repair; however, no significant differences in ultimate tensile strength between repair groups were discerned (P > 0.05).

CONCLUSION

The cruciate suture repair construct, which may represent a simple and cost-effective alternative to double-row and double-row equivalent rotator cuff repairs, has comparable biomechanical strength and integrity with that of the SutureBridge repair, and may result in improved construct longevity and tendon healing compared with the Mason-Allen repair.

摘要

背景

与单排修复相比,双排肩袖肌腱修复技术可能提供更大的接触面积和更强的强度,但材料费用更高且手术时间更长。本研究的目的是评估单排十字缝线肩袖修复结构的间隙形成、极限抗拉强度和刚度,并将这些结果与梅森 - 艾伦(Mason-Allen)和缝线桥(SutureBridge)修复结构的结果进行比较。

方法

从24只春季羔羊肩部获取冈下肌腱,并分配到十字缝线、梅森 - 艾伦和缝线桥修复组。标本在10至62 N之间循环加载200次,同时使用高速数码相机测量间隙形成。然后对标本进行单轴拉伸直至破坏,并评估结构刚度和修复强度。

结果

十字缝线修复中的间隙形成明显低于梅森 - 艾伦修复(平均差异 = 0.6 mm,P = 0.009),与缝线桥修复无差异(P > 0.05)。十字缝线修复(平均差异 = 15.7 N/mm,P = 0.002)和缝线桥修复(平均差异 = 15.8 N/mm,P = 0.034)均明显比梅森 - 艾伦修复更硬;然而,修复组之间的极限抗拉强度没有显著差异(P > 0.05)。

结论

十字缝线修复结构可能是双排和等效双排肩袖修复的一种简单且经济有效的替代方法,其生物力学强度和完整性与缝线桥修复相当,与梅森 - 艾伦修复相比,可能会提高结构的耐久性和肌腱愈合能力。

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