Kramer Jonathan D, Robinson Sean, Purviance Connor, Montgomery William
St. Mary's Medical Center, San Francisco Orthopedic Residency Program, 450 Stanyan St, San Francisco, CA 94115, United States.
The Taylor Collaboration, 450 Stanyan St, San Francisco, CA 94115, United States.
J Orthop. 2018 Feb 2;15(1):102-106. doi: 10.1016/j.jor.2018.01.049. eCollection 2018 Mar.
All-suture anchors used in arthroscopic shoulder stabilization employ small diameter anchors, which allow greater placement density on narrow surfaces such as the glenoid. There is no consensus in the literature about how close to one another two anchors may be implanted.
The purpose of the present study is to compare the strength characteristics of two all-suture anchors placed in cadaveric human glenoid at variable distances to one another, in order to determine the minimum distance required for optimal strength.
Twelve fresh-frozen human cadaveric glenoids were implanted with 1.4 mm all-suture anchors at varying inter-anchor distances. Each glenoid was used for four tests, for a total of 48 tests. Anchors were implanted adjacent to one another or with 2, 3, or 5 mm bone bridges between pilot holes. The glenoids then underwent pullout testing using a test frame with a 5N preload followed by displacement of 12.5 mm/s. The primary outcomes were stiffness, failure strength, and ultimate strength.
Stiffness was 13.52 ± 3.8, 17.97 ± 5.02, 17.59 ± 4.65 and 18.95 ± 4.67 N/mm for the adjacent, 2, 3, and 5 mm treatment groups, respectively. The adjacent group had a significantly lower stiffness compared to the other treatment groups. Failure strength was 48.68 ± 20.64, 76.16 ± 23.78, 73.19 ± 35.83 and 87.04 ± 34.67 N for the adjacent, 2, 3, and 5 mm treatment groups, respectively. The adjacent group had a significantly lower failure strength compared to the other treatment groups. Ultimate strength was also measured to be 190.59 ± 140.93, 268.7 ± 115.1, 283.23 ± 118.43, and 291.28 ± 118.24 for the adjacent, 2, 3, and 5 mm treatment groups, respectively.
This biomechanical study provides evidence that 1.4 mm all-suture anchors demonstrate similar strength characteristics when placed at least 2 mm or greater from one another. When 1.4 mm all-suture anchors were placed adjacent to one another, there was an observed decrease in failure strength and stiffness.
This study suggests that 1.4 mm all-suture anchors may be placed as close as 2 mm to one another while preserving strength characteristics.
用于关节镜下肩关节稳定手术的全缝线锚钉采用小直径锚钉，这使得在诸如肩胛盂等狭窄表面上能够实现更高的植入密度。关于两个锚钉可以彼此植入多近，文献中尚无共识。
本研究的目的是比较在尸体人肩胛盂中以不同距离放置的两个全缝线锚钉的强度特性，以确定获得最佳强度所需的最小距离。
在十二个新鲜冷冻的人尸体肩胛盂中以不同的锚钉间距植入1.4毫米的全缝线锚钉。每个肩胛盂用于四项测试，总共进行48项测试。锚钉彼此相邻植入，或者在导向孔之间留有2、3或5毫米的骨桥。然后使用具有5N预载并随后以12.5毫米/秒的位移的测试框架对肩胛盂进行拔出测试。主要结果是刚度、破坏强度和极限强度。
相邻、2毫米、3毫米和5毫米治疗组的刚度分别为13.52±3.8、17.97±5.02、17.59±4.65和18.95±4.67N/mm。与其他治疗组相比，相邻组的刚度明显较低。相邻、2毫米、3毫米和5毫米治疗组的破坏强度分别为48.68±20.64、76.16±23.78、73.19±35.83和87.04±34.67N。与其他治疗组相比，相邻组的破坏强度明显较低。相邻、2毫米、3毫米和5毫米治疗组的极限强度也分别测量为190.59±140.93、268.7±115.1、283.23±118.43和291.28±118.24。
这项生物力学研究提供了证据，即1.4毫米的全缝线锚钉彼此相距至少2毫米或更远时，显示出相似的强度特性。当1.4毫米的全缝线锚钉彼此相邻放置时，观察到破坏强度和刚度有所下降。
本研究表明，1.4毫米的全缝线锚钉可以彼此相距2毫米放置，同时保持强度特性。
