Department of Orthopaedic Surgery, Carolinas Medical Center, Charlotte, North Carolina, U.S.A.
Tahoe Forest Health System, Truckee, California, U.S.A.
Arthroscopy. 2018 Oct;34(10):2777-2781. doi: 10.1016/j.arthro.2018.05.030. Epub 2018 Sep 6.
To evaluate the effect of greater tuberosity decortication on ultimate load to failure and displacement after cyclic loading with an all-suture anchor.
A 2.9-mm all-suture anchor was evaluated in decorticated and nondecorticated greater tuberosities of 10 matched pairs of human cadaveric shoulders. Greater tuberosity decortication was performed to a mean depth of 1.7 mm. Anchors were placed in the anterior, middle, and posterior tuberosity. Anchors were tested under cyclic loads followed by load-to-failure testing. Displacement after 20, 100, and 200 cycles and ultimate failure strength were determined. Clinical failure was defined as displacement greater than 5 mm during cyclic loading.
After 20 and 100 cycles, there was no difference in mean displacement between the decorticated and nondecorticated cohorts (P = .139 and P = .127, respectively). The mean displacement after 200 cycles was greater in the decorticated cohort, although not significantly (3.4 vs 2.7 mm; P = .05). The mean ultimate load to failure was significantly lower in the decorticated cohort (314 vs 386 N, P = .049). There were 2 clinical failures in the decorticated specimens and 1 in the nondecorticated specimens.
A minimal greater tuberosity decortication significantly decreases the ultimate load to failure of an all-suture anchor. However, decreased biomechanical strength may not necessitate actual clinical failure.
A decrease in ultimate load to failure could increase the risk of catastrophic postoperative anchor failure. However, while this decrease in strength is statistically significant, the overall decrease in strength may not be sufficient in magnitude to translate to clinical failure.
评估全缝线锚钉在前盂唇骨皮质骨钻孔对循环加载后最终失效载荷和位移的影响。
在 10 对匹配的人尸体肩关节的去皮质和未去皮质的大结节中评估了 2.9mm 的全缝线锚钉。大结节去皮质至平均深度 1.7mm。将锚钉放置在前、中、后盂唇。在循环负荷下测试锚钉，然后进行失效负荷测试。测定 20、100 和 200 个循环后的位移和最终失效强度。临床失效定义为在循环加载过程中位移大于 5mm。
在 20 和 100 个循环后，去皮质和未去皮质队列的平均位移没有差异（P=0.139 和 P=0.127）。去皮质队列在 200 个循环后的平均位移更大，但差异无统计学意义（3.4 对 2.7mm；P=0.05）。去皮质队列的最终失效载荷明显较低（314 对 386N，P=0.049）。去皮质标本中有 2 个临床失效，未去皮质标本中有 1 个。
最小程度的大结节去皮质显著降低了全缝线锚钉的最终失效载荷。然而，生物力学强度的降低可能不一定导致实际的临床失效。
最终失效载荷的降低会增加灾难性术后锚钉失效的风险。然而，尽管这种强度的降低在统计学上有意义，但总体强度的降低可能不足以导致临床失效。
