Zhang Tao, Hatta Taku, Thoreson Andrew R, Lu ChengChang, Steinmann Scott P, Moran Steven L, Zhao Chunfeng
Biomechanics Laboratory, Division of Orthopedic Research, Department of Orthopedic Surgery, Mayo Clinic, 200 First St SW, Rochester, Minnesota, 55905.
Joint Surgery and Sports Medicine, Jinan Central Hospital, Shandong, 250013, China.
J Orthop Res. 2018 Mar;36(3):987-992. doi: 10.1002/jor.23668. Epub 2017 Aug 21.
Surgical repair is a common treatment for rotator cuff tear; however, the retear rate is high. A high degree of suture repair strength is important to ensure rotator cuff integrity for healing. The purpose of this study was to compare the mechanical performance of rotator cuffs repaired with a mesh suture versus traditional polydioxanone suture II and FiberWire sutures in a canine in vitro model. Seventy-two canine shoulders were harvested. An infraspinatus tendon tear was created in each shoulder. Two suture techniques-simple interrupted sutures and two-row suture bridge-were used to reconnect the infraspinatus tendon to the greater tuberosity, using three different suture types: Mesh suture, polydioxanone suture II, or FiberWire. Shoulders were loaded to failure under displacement control at a rate of 20 mm/min. Failure load was compared between suture types and techniques. Ultimate failure load was significantly higher in the specimens repaired with mesh suture than with polydioxanone suture II or FiberWire, regardless of suture technique. There was no significant difference in stiffness among the six groups, with the exception that FiberWire repairs were stiffer than polydioxanone suture II repairs with the simple interrupted technique. All specimens failed by suture pull-out from the tendon. Based on our biomechanical findings, rotator cuff repair with the mesh suture might provide superior initial strength against failure compared with the traditional polydioxanone suture II or FiberWire sutures. Use of the mesh suture may provide increased initial fixation strength and decrease gap formation, which could result in improved healing and lower re-tear rates following rotator cuff repair. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:987-992, 2018.
手术修复是肩袖撕裂的常见治疗方法；然而，再撕裂率很高。高度的缝合修复强度对于确保肩袖愈合的完整性很重要。本研究的目的是在犬类体外模型中比较使用网状缝线与传统聚二氧六环酮缝线II和FiberWire缝线修复肩袖的力学性能。收集了72个犬类肩部。在每个肩部制造冈下肌腱撕裂。使用两种缝合技术——单纯间断缝合和双排缝合桥——将冈下肌腱重新连接到大结节，使用三种不同的缝合类型：网状缝线、聚二氧六环酮缝线II或FiberWire。肩部在位移控制下以20毫米/分钟的速度加载至失效。比较不同缝合类型和技术之间的失效载荷。无论缝合技术如何，用网状缝线修复的标本的极限失效载荷显著高于用聚二氧六环酮缝线II或FiberWire修复的标本。六组之间的刚度没有显著差异，唯一的例外是采用单纯间断技术时，FiberWire修复比聚二氧六环酮缝线II修复更硬。所有标本均因缝线从肌腱中拔出而失效。基于我们的生物力学研究结果，与传统的聚二氧六环酮缝线II或FiberWire缝线相比，用网状缝线修复肩袖可能提供更好的抗失效初始强度。使用网状缝线可能会增加初始固定强度并减少间隙形成，这可能会改善愈合并降低肩袖修复后的再撕裂率。©2017骨科学研究协会。由威利期刊公司出版。《矫形外科学研究》36:987 - 992，2018年。
