Hoburg Arnd, von Roth Philipp, Roy-Ali Shimon, Ode Jan-Erik, Wulsten Dag, Jung Tobias M, Gwinner Clemens
Center for Musculoskeletal Surgery, Charité, Universitaetsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.
Charité Core Facility (Centrum wissenschaftliche Werkstaetten), Charité, Universitaetsmedizin Berlin, Berlin, Germany.
Arch Orthop Trauma Surg. 2018 Apr;138(4):537-542. doi: 10.1007/s00402-018-2883-3. Epub 2018 Jan 24.
Clinical reports on meniscal scaffolds seem promising, albeit relatively paucity exists regarding their biomechanical behavior. The aim of the study is to delineate the impact of differing suture materials and the type as well as the temperature of the irrigation fluid on the pull-out strength of a polyurethane meniscal scaffold (Actifit).
128 specimens were utilized with horizontal sutures and uniaxial load-to-failure testing was performed. We compared two different suture materials-polydioxanone (PDS) and non-absorbable, braided polyester sutures (NABP)-as well as two common irrigation fluids-lactated Ringer's and electrolyte-free, hypotonic Mannitol-Sorbitol. All specimens were further evaluated according to two different temperatures [room temperature (20 °C) and near-core body temperature (37 °C)].
Mean load-to-failure was 53.3 ± 6.5 N. There was no significant difference between the NABP and the PDS group. Ringer group showed a significantly higher load-to-failure compared to Purisole (P = .0002). This was equivalent for both PDS (P = .0008) and NABP sutures (P = .0008). Significantly higher failure loads could be established for the 37° group (P = .041); yet, this difference was neither confirmed for the PDS or in in the NABP subgroup. Only the subgroup using Purisole at 37° showed significantly higher failure loads compared to 20° (P = .017).
This study underlines the potential to improve pull-out strength during implantation of an Actifit scaffold by alteration of the type of irrigation fluid. Lactated Ringer solution provided the highest construct stability in regard to load-to-failure testing and should be considered whenever implantation of a polyurethane meniscal scaffold is conducted.
关于半月板支架的临床报告似乎很有前景，尽管关于其生物力学行为的研究相对较少。本研究的目的是描述不同缝合材料、冲洗液类型以及温度对聚氨酯半月板支架（Actifit）拔出强度的影响。
使用128个标本进行水平缝合，并进行单轴破坏载荷测试。我们比较了两种不同的缝合材料——聚二氧六环酮（PDS）和不可吸收的编织聚酯缝线（NABP），以及两种常用的冲洗液——乳酸林格氏液和无电解质的低渗甘露醇 - 山梨醇溶液。所有标本根据两个不同温度[室温（20°C）和接近核心体温（37°C）]进一步评估。
平均破坏载荷为53.3±6.5N。NABP组和PDS组之间没有显著差异。与Purisole相比，林格氏液组的破坏载荷显著更高（P = 0.0002）。这在PDS（P = 0.0008）和NABP缝线（P = 0.0008）中都是如此。37°组的破坏载荷显著更高（P = 0.041）；然而，这种差异在PDS或NABP亚组中均未得到证实。只有在37°使用Purisole的亚组与20°相比显示出显著更高的破坏载荷（P = 0.017）。
本研究强调了通过改变冲洗液类型来提高Actifit支架植入过程中拔出强度的潜力。就破坏载荷测试而言，乳酸林格氏液提供了最高的结构稳定性，在进行聚氨酯半月板支架植入时应予以考虑。
