Koh Jason L, Gupta Kavish
NorthShore Orthopaedic Institute, NorthShore University HealthSystem, Evanston, Illinois - USA.
Hip Int. 2017 Feb 21;27(1):104-109. doi: 10.5301/hipint.5000472. Epub 2017 Jan 24.
Repairs of labral tears are performed for unstable tears, hip instability, and after detachment concomitant to the treatment of femoroacetabular impingement (FAI), but limited data is known about the strength of repair. This study evaluated the effect of simulated axial weight-bearing on suture anchor based repair of the acetabular labrum.
3 cadaveric pelvises underwent creation of a 1.5 cm anterior-superior labral tear in each hip. The tears were then repaired using 2 suture anchors per hip. Following repair, the hip joint underwent axial cyclic loading to 756 N, and were inspected for separation of the labrum from the acetabulum. The strength of the suture anchor repair was evaluated by testing load to failure, in-line with insertion.
Upon visual examination, all 6 repairs remained fully intact following loading with no visible gap formation or damage at the repair site. In all cases an arthroscopic probe could not be inserted under the edge of the repair. The mean failure force of the 12 suture anchors, in-line with insertion, was 154 N ± 44 N.
Acetabular labral suture anchor repairs may be able to immediately withstand the physiological loads of axial weight-bearing. Labral repair may be able to tolerate axial weight-bearing immediately after repair, preserving the strength and integrity of muscles and soft tissues.
髋臼唇撕裂修复用于治疗不稳定撕裂、髋关节不稳定以及在股骨髋臼撞击症(FAI)治疗中伴有髋臼唇撕裂时,但关于修复强度的数据有限。本研究评估了模拟轴向负重对基于缝合锚钉的髋臼唇修复的影响。
对3具尸体骨盆的每个髋关节制造一个1.5厘米的前上髋臼唇撕裂。然后每个髋关节使用2个缝合锚钉进行修复。修复后,髋关节进行轴向循环加载至756牛,并检查髋臼唇与髋臼的分离情况。通过测试直至失败的负荷来评估缝合锚钉修复的强度,负荷方向与植入方向一致。
肉眼检查时,所有6处修复在加载后均保持完全完整,修复部位无可见间隙形成或损伤。在所有病例中,关节镜探针均无法插入修复边缘下方。12个缝合锚钉在植入方向上的平均破坏负荷为154牛±44牛。
髋臼唇缝合锚钉修复可能能够立即承受轴向负重的生理负荷。髋臼唇修复在修复后可能能够立即耐受轴向负重,保持肌肉和软组织的强度及完整性。