Department of Orthopaedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan; Medical Device Innovation Center, National Cheng Kung University, Tainan, Taiwan.
Arthroscopy. 2018 Jun;34(6):1755-1761. doi: 10.1016/j.arthro.2018.01.007. Epub 2018 Feb 23.
To compare the biomechanical properties of an transtendinous all-suture anchor technique with the commonly-accepted interference screw technique in a cadaveric model.
Sixteen fresh-frozen human cadaveric shoulders (mean age, 67.6 ± 5.8 years) were used and were randomly divided into 2 experimental long head of the biceps brachii (LHB) tenodesis groups (n = 8), namely transtendinous all-suture anchor technique and interference screw technique. The location of tenodesis was in the bicipital groove, 1 cm distal to the proximal border of the bicipital groove. Tensile force parallel to the longitudinal axis of the humerus was applied to each specimen. A preload of 5 N was applied for 2 minutes, followed by cyclic loading for 500 cycles from 5 to 70 N at 1 Hz; then, a load-to-failure test at 1 mm/s was performed. The ultimate failure load, stiffness, cyclic displacement, failure displacement, and failure modes were recorded.
The transtendinous all-suture anchor technique provided similar ultimate failure load and stiffness as the interference screw technique. However, the cyclic and failure displacements of the transtendinous all-suture anchor technique were significantly greater than the interference screw technique (P = .009 and .021, respectively). Six specimens in the transtendinous all-suture anchor group failed because of suture anchor pullout, while failure of the other 2 was caused by tendon tear; by contrast, all specimens in the interference screw group failed because of tendon tear.
The transtendinous all-suture anchor technique for LHB tenodesis offered equivalent ultimate failure load and stiffness but had significantly larger cyclic and failure displacement values when compared with the interference screw technique in this cadaveric biomechanical study.
The transtendinous all-suture anchor technique is an alternative technique for suprapectoral LHB tenodesis; however, care should be taken because only time zero biomechanical data are available.
比较经腱全缝线锚定技术与常用的干扰螺钉技术在尸体模型中的生物力学性能。
使用 16 个新鲜冷冻的人尸体肩关节（平均年龄，67.6±5.8 岁），并随机分为 2 个实验组（长头肌腱肱二头肌（LHB）固定术），即经腱全缝线锚定技术和干扰螺钉技术。固定术的位置在肱二头肌沟内，距肱二头肌沟近端边界 1cm 处。向每个标本施加与肱骨纵轴平行的拉力。先施加 5N 的预载 2 分钟，然后以 1Hz 的频率从 5N 至 70N 进行 500 次循环加载；然后以 1mm/s 的速度进行失效负载测试。记录最终失效负载、刚度、循环位移、失效位移和失效模式。
经腱全缝线锚定技术提供的最终失效负载和刚度与干扰螺钉技术相似。然而，经腱全缝线锚定技术的循环和失效位移明显大于干扰螺钉技术（P=0.009 和 0.021）。经腱全缝线锚定组 6 个标本因缝线锚钉拔出而失效，而另外 2 个标本因肌腱撕裂而失效；相比之下，干扰螺钉组的所有标本均因肌腱撕裂而失效。
在这项尸体生物力学研究中，与干扰螺钉技术相比，LHB 固定的经腱全缝线锚定技术提供了等效的最终失效负载和刚度，但循环和失效位移值明显更大。
经腱全缝线锚定技术是一种替代的肩上方 LHB 固定技术；然而，由于只有零时间的生物力学数据可用，因此应谨慎使用。
