Camarda Lawrence, Pitarresi Giuseppe, Lauria Michele, Fazzari Federico, D'Arienzo Michele
Department of Orthopaedic Surgery (DiChirOnS), University of Palermo, Via del Vespro, Palermo, Italy.
Dipartimento di Ingegneria Chimica, Gestionale, Informatica e Meccanica (DICGIM), University of Palermo, Viale delle Scienze, Palermo, Italy.
Arch Orthop Trauma Surg. 2017 Sep;137(9):1301-1306. doi: 10.1007/s00402-017-2739-2. Epub 2017 Jul 3.
To investigate the effect of applying an additional suture to enhance the biomechanical behavior of the suture-meniscus construct used during the transtibial pull-out repair technique.
A total of 20 fresh-frozen porcine tibiae with intact medial menisci were used. In one half of all specimens (N = 10), two non-absorbable sutures were passed directly over the meniscal root from the tibia side of the meniscus to the femoral side (2SS). In other ten specimens, three sutures were passed over the meniscal root (3SS). All specimens were subjected to cyclic loading followed by load-to-failure testing. Displacement of the construct was recorded at 100, 500, and 1000 cycles. Further, stiffness (500-1000 cycles) and ultimate load and modes of failure of the suture-meniscus construct were also recorded.
There was no statistically significant difference between the Group 2SS and Group 3SS at the 1st (1.6 ± 0.7 vs 1.4 ± 0.4 mm) and the 100th cycle (2 ± 0.7 vs 1.8 ± 0.4 mm). At 500 and 1000 cycles, the 2SS fixation technique resulted in significantly more displacement than the 3SS fixation technique (2.8 ± 0.6 vs 2.3 ± 0.5 mm; 3.1 ± 0.7 vs 2.5 ± 0.5 mm) (p < 0.05). No differences between two groups were noted concerning ultimate load to failure and stiffness (500-1000 cycles).
Three single sutures technique provided superior biomechanical properties compared with the two single sutures technique during the conducted fatigue tests.
Applying three simple stitches during meniscal root repair might be beneficial for healing of the posterior meniscal root, potentially reducing the post-operative immobilization time.
研究在经胫骨拉出修复技术中应用额外缝线以增强缝线 - 半月板结构生物力学性能的效果。
共使用20个带有完整内侧半月板的新鲜冷冻猪胫骨。在所有标本的一半（N = 10）中，两条不可吸收缝线直接从半月板胫骨侧穿过半月板根部至股骨侧（2SS）。在另外10个标本中，三条缝线穿过半月板根部（3SS）。所有标本先进行循环加载，然后进行破坏载荷测试。在100、500和1000个循环时记录结构的位移。此外，还记录了刚度（500 - 1000个循环）、缝线 - 半月板结构的极限载荷和破坏模式。
在第1个循环（1.6 ± 0.7对1.4 ± 0.4毫米）和第100个循环（2 ± 0.7对1.8 ± 0.4毫米）时，2SS组和3SS组之间无统计学显著差异。在500和1000个循环时，2SS固定技术导致的位移明显多于3SS固定技术（2.8 ± 0.6对2.3 ± 0.5毫米；3.1 ± 0.7对2.5 ± 0.5毫米）（p < 0.05）。两组在破坏极限载荷和刚度（500 - 1000个循环）方面未发现差异。
在进行的疲劳试验中，与两条单缝线技术相比，三条单缝线技术具有更好的生物力学性能。
在半月板根部修复过程中应用三条简单缝线可能有利于半月板后根部的愈合，潜在地减少术后固定时间。
