Liu Rui Wen, Lam Patrick Hong, Shepherd Henry M, Murrell George A C
Orthopaedic Research Institute, Kogarah, New South Wales, Australia.
Orthop J Sports Med. 2017 Apr 17;5(4):2325967117701212. doi: 10.1177/2325967117701212. eCollection 2017 Apr.
Rotator cuff retears after surgical repair are associated with poorer subjective and objectives clinical outcomes than intact repairs.
The aims of this study were to (1) examine the biomechanical differences between rotator cuff repair using No. 2 suture and tape in an ovine model and (2) compare early clinical outcomes between patients who had rotator cuff repair with tape and patients who had repair with No. 2 suture.
Controlled laboratory study and cohort study; Level of evidence, 3.
Biomechanical testing of footprint contact pressure and load to failure were conducted with 16 ovine shoulders using a tension band repair technique with 2 different types of sutures (No. 2 suture [FiberWire; Arthrex] and tape [FiberTape; Arthrex]) with the same knotless anchor system. A retrospective study of 150 consecutive patients (tape, n = 50; suture, n = 100) who underwent arthroscopic rotator cuff repair by a single surgeon with tear size larger than 1.5 × 1 cm was conducted. Ultrasound was used to evaluate the repair integrity at 6 months postsurgery.
Rotator cuff repair using tape had greater footprint contact pressure (mean ± standard error of the mean, 0.33 ± 0.03 vs 0.11 ± 0.3 MPa; < .0001) compared with repair using No. 2 sutures at 0° abduction with a 30-N load applied across the repaired tendon. The ultimate failure load of the tape repair was greater than that for suture repair (217 ± 28 vs 144 ± 14 N; < .05). The retear rate was similar between the tape (16%; 8/50) and suture groups (17%; 17/100).
Rotator cuff repair with the wider tape compared with No. 2 suture did not affect the retear rate at 6 months postsurgery, despite having superior biomechanical properties.
与完整修复相比，肩袖手术修复后的再撕裂与较差的主观和客观临床结果相关。
本研究的目的是：（1）在绵羊模型中检查使用2号缝线和带进行肩袖修复之间的生物力学差异；（2）比较使用带进行肩袖修复的患者和使用2号缝线进行修复的患者的早期临床结果。
对照实验室研究和队列研究；证据等级，3级。
使用张力带修复技术，对16只绵羊的肩部进行足迹接触压力和失效负荷的生物力学测试，使用2种不同类型的缝线（2号缝线[FiberWire；Arthrex]和带[FiberTape；Arthrex]）以及相同的无结锚钉系统。对150例连续患者（带组，n = 50；缝线组，n = 100）进行回顾性研究，这些患者由同一位外科医生进行关节镜下肩袖修复，撕裂大小大于1.5×1 cm。术后6个月使用超声评估修复完整性。
在0°外展、对修复肌腱施加30 N负荷时，与使用2号缝线修复相比，使用带进行肩袖修复具有更大的足迹接触压力（平均值±平均标准误差，0.33±0.03 vs 0.11±0.3 MPa；P <.0001）。带修复的极限失效负荷大于缝线修复（217±28 vs 144±14 N；P <.05）。带组（16%；8/50）和缝线组（17%；17/100）的再撕裂率相似。
与2号缝线相比，使用更宽的带进行肩袖修复在术后6个月时不影响再撕裂率，尽管其具有更好的生物力学性能。
