Perez-Blanca Ana, Prado Nóvoa María, Lombardo Torre Maximiano, Espejo-Reina Alejandro, Ezquerro Juanco Francisco, Espejo-Baena Alejandro
Andalucía Tech, Laboratorio de Biomecánica, Departamento de Ingeniería Mecánica, Universidad de Málaga, C/ Pedro Ortiz Ramos, s/n., Málaga, 29071, Spain.
Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Virgen de la Victoria, Málaga, Spain.
Int Orthop. 2018 Apr;42(4):811-818. doi: 10.1007/s00264-018-3799-9. Epub 2018 Feb 2.
To assess the role of suture cutout in the mechanics of failure of the repaired posterior meniscal root during the early post-operative period when using sutures of different shape.
Twenty medial porcine menisci were randomized in two groups depending on the suture shape used to repair the posterior root: thread or tape. The sutured menisci were subjected to cyclic loading (1000 cycles, (10, 30) N) followed by load-to-failure testing. Residual displacements, stiffness, and ultimate failure load were determined. During tests, the tissue-suture interface was recorded using a high-resolution camera.
In cyclic tests, cutout progression at the suture insertion points was not observed for any specimen of either group and no differences in residual displacements were found between use of thread or tape. In load-to-failure tests, suture cutout started in all menisci at a load close to the ultimate failure and all specimens failed by suture pullout. Suture tape had a greater ultimate load with no other differences.
In a porcine model of a repaired posterior meniscal root subjected to cyclic loads representative of current rehabilitation protocols in the early post-operative period under restricted loading conditions, suture cutout was not found as a main source of permanent root displacement when using suture thread or tape. Suture cutout progression started at high loading levels close to the ultimate load of the construct. Tape, with a meniscus-suture contact area larger than thread, produced higher ultimate load.
评估在术后早期使用不同形状缝线修复后半月板根部时，缝线穿出在修复后半月板根部失效力学中的作用。
根据用于修复后根部的缝线形状，将20个猪内侧半月板随机分为两组：线或带。对缝合后的半月板进行循环加载（1000次循环，(10, 30) N），然后进行破坏载荷测试。测定残余位移、刚度和极限破坏载荷。在测试过程中，使用高分辨率相机记录组织-缝线界面。
在循环测试中，两组的任何标本在缝线插入点均未观察到穿出进展，使用线或带之间在残余位移上未发现差异。在破坏载荷测试中，所有半月板在接近极限破坏的载荷下开始出现缝线穿出，所有标本均因缝线拔出而失效。缝线带的极限载荷更大，无其他差异。
在猪后半月板根部修复模型中，在术后早期受限加载条件下，施加代表当前康复方案的循环载荷时，使用缝线或缝线带时，缝线穿出未被发现是永久根部位移的主要来源。缝线穿出进展在接近结构极限载荷的高加载水平时开始。带与半月板-缝线的接触面积大于线，产生更高的极限载荷。
