Léger-St-Jean Benjamin, Ménard Jérémie, Hinse Stéphanie, Balg Frédéric, Rouleau Dominique M
Université de Montréal, Montreal, Québec, Canada.
Hôpital du Sacré-Cœur de Montréal, Montreal, Québec, Canada.
Shoulder Elbow. 2017 Apr;9(2):85-91. doi: 10.1177/1758573216679945. Epub 2016 Nov 21.
To help determine the optimal fixation method for subscapularis tendon repair in arthroplasty, the present study compares single-passage transosseous tape (BT) and modified Mason-Allen #2 suture (MA).
Eighteen human cadaveric shoulders were randomized to two repair constructs after arthroplasty preparation. Both techniques included two transosseous passages through the bicipital groove and then through the tendon at the level of the anatomical neck. Construct was tested using a traction machine, measuring cyclic loading and ultimate load to failure.
The mean age of our specimens was 71 years. No significant difference was observed between the repair techniques in both mean ultimate load and cyclic loading. The mean (SD) ultimate load (UL) for BT was 293 (84) N and 342 (117) N for MA, which was not statistically significant ( = 0.374). The majority of repairs failed in the tendon. Bone cut-out was observed with the MA but not for the BT repair. No correlation was found between bone density and UL for BT ( = -0.09) but there was strong correlation for MA ( = 0.63).
The MA repair appears to be more dependant on bone mineral density for ultimate load, indicating that braided-tape might be better suited for osteoporotic patients to avoid bone cut-out.
为了帮助确定关节成形术中肩胛下肌腱修复的最佳固定方法,本研究比较了单通道骨隧道带线锚钉(BT)和改良的梅森-艾伦2号缝线(MA)。
18具人类尸体肩部在进行关节成形术准备后被随机分为两种修复结构。两种技术都包括在二头肌沟处穿过两个骨隧道,然后在解剖颈水平穿过肌腱。使用牵引机对结构进行测试,测量循环载荷和极限破坏载荷。
我们标本的平均年龄为71岁。两种修复技术在平均极限载荷和循环载荷方面均未观察到显著差异。BT的平均(标准差)极限载荷(UL)为293(84)N,MA为342(117)N,差异无统计学意义(P = 0.374)。大多数修复在肌腱处失败。MA修复观察到骨块脱出,而BT修复未观察到。BT的骨密度与UL之间未发现相关性(P = -0.09),但MA有很强的相关性(P = 0.63)。
MA修复的极限载荷似乎更依赖于骨矿物质密度,这表明编织带可能更适合骨质疏松患者以避免骨块脱出。