University of Utah Department of Orthopaedics, Salt Lake City, Utah, U.S.A..
KATOR LLC, Logan, Utah, U.S.A.
Arthroscopy. 2018 Jan;34(1):58-63. doi: 10.1016/j.arthro.2017.08.253. Epub 2017 Nov 1.
To compare the biomechanics of a transosseous equivalent (TOE) repair using medial and lateral anchors with tape to a transosseous knotless (TOK) tape repair with only laterally placed intraosseous anchors.
One of 2 different repairs were performed on 8 paired specimens: (1) transosseous equivalent (TOE) tape repair or (2) transosseous knotless (TOK) tape repair. Specimens were mounted on a materials testing machine and loaded in uniaxial tension to measure cyclic construct gap formation, followed by failure testing. Paired t tests were used to compare gapping, ultimate stiffness, and failure loads. Fisher exact test was used to compare modes of failure (soft tissue failure vs construct failure).
Peak cyclic gapping, failure stiffness, and ultimate failure loads did not differ between TOE and TOK repairs (P = .140 for gapping, P = .106 for stiffness, and P = .672 for peak failure loads). All TOK repairs failed via soft tissue failure medial to the medial suture line, with no construct failures. TOE repairs failed more often through construct failure (anchor migration or suture-bone interface cut through) than TOK repairs (P = .026).
TOK repairs only failed through soft tissue whereas TOE repairs failed through both soft tissue and the repair construct. Despite 50% fewer suture anchors in the TOK repairs than the TOE repairs, cyclic gapping and ultimate stiffness and failure loads were not significantly different.
The transosseous knotless construct presented is a 2-anchor construct that is equivalent in biomechanical function to a traditional 4-anchor construct, reducing anchor load in the tuberosity.
比较经皮骨道锚钉（TOE）修复中内侧和外侧锚钉联合缝线与单纯外侧锚钉的经皮骨道免打结（TOK）缝线修复的生物力学。
对 8 对标本中的每一对标本进行以下两种不同修复之一：（1）经皮骨道锚钉（TOE）修复，或（2）经皮骨道免打结（TOK）修复。标本安装在材料试验机上，进行单轴拉伸以测量循环构建间隙形成，然后进行失效测试。使用配对 t 检验比较间隙、最终刚度和失效载荷。Fisher 精确检验用于比较失效模式（软组织失效与构建失效）。
TOE 和 TOK 修复之间的峰值循环间隙、失效刚度和最终失效载荷没有差异（间隙 P =.140，刚度 P =.106，峰值失效载荷 P =.672）。所有 TOK 修复均通过内侧缝线内侧的软组织失效而失效，无构建失效。TOE 修复更常通过构建失效（锚钉迁移或缝线-骨界面穿透）而失效，而 TOK 修复较少（P =.026）。
TOK 修复仅通过软组织失效，而 TOE 修复通过软组织和修复构建同时失效。尽管 TOK 修复的缝线锚钉数量比 TOE 修复少 50%，但循环间隙、最终刚度和失效载荷没有显著差异。
所提出的经皮骨道免打结构建是一种 2 锚钉构建，其生物力学功能与传统的 4 锚钉构建相当，减少了结节内的锚钉负荷。
