Huntington Lachlan, Coles-Black Jasamine, Richardson Martin, Sobol Tony, Caldow Jonathon, Chuen Jason, Ackland David C
Department of Biomedical Engineering, University of Melbourne, Parkville, Victoria, 3010, Australia.
Department of Surgery, Austin Health, Melbourne Medical School, The University of Melbourne, Parkville, Victoria, 3010, Australia.
Injury. 2018 Nov;49(11):2047-2052. doi: 10.1016/j.injury.2018.09.004. Epub 2018 Sep 6.
Rotator cuff repair surgery aims to create a secure, pressurized tendon-bone footprint to permit re-establishment of the fibrovascular interface and tendon healing. Flat-braided suture-tape is an alternative suture material to traditional suture-wire that has potential to reproduce a larger repair construct contact area. The objective of this study was to compare contact pressure, area as well as the mechanical fatigue strength between suture-wire and suture-tape Suture-bridge repair constructs in an ovine model.
Sixty lamb infraspinatus tendons were harvested and randomly allocated to three- and four-anchor Suture-bridge repairs performed using either suture-wire or suture-tape. Thirty-two specimens were cyclically loaded for 200 cycles in an Instron testing machine, while tendon gap formation was recorded using a high speed digital motion analysis system. Loading to failure was then performed to evaluate construct ultimate tensile strength and stiffness. The remaining 28 specimens were assessed for repair contact pressure and area using pressure-sensitive film.
There was a significantly greater average tendon contact pressure (mean difference: 0.064 MPa, p = 0.04) and area (mean difference: 2.71 mm, p = 0.03) in fiber-tape repair constructs compared to those in fiber-wire constructs for the three-anchor Suture-bridge configuration. The four-anchor suture-tape constructs had a significantly larger ultimate tensile strength than that of the four-anchor suture-wire constructs (mean difference: 56.4 N, p = 0.04). There were no significant differences in gap formation or stiffness between suture-tape and suture-wire constructs (p > 0.05).
Suture-tape offers greater pressurised tendon-bone contact than suture-wire in three-anchor Suture-bridge repairs, while greater mechanical strength is achieved with the use of suture-tape in four-anchor Suture-bridge constructs.
肩袖修复手术旨在创建一个安全、加压的肌腱-骨附着区，以促进纤维血管界面的重建和肌腱愈合。扁平编织缝合带是传统缝合线的一种替代缝合材料，有可能产生更大的修复结构接触面积。本研究的目的是比较缝合线和缝合带缝合桥修复结构在绵羊模型中的接触压力、面积以及机械疲劳强度。
收集60条羊的冈下肌腱，随机分配到使用缝合线或缝合带进行的三锚和四锚缝合桥修复组。32个标本在Instron试验机上进行200次循环加载，同时使用高速数字运动分析系统记录肌腱间隙形成情况。然后进行加载至破坏试验，以评估结构的极限拉伸强度和刚度。其余28个标本使用压敏膜评估修复接触压力和面积。
对于三锚缝合桥构型，与纤维线结构相比，纤维带修复结构的平均肌腱接触压力显著更大（平均差异：0.064MPa，p = 0.04），面积也显著更大（平均差异：2.71mm，p = 0.03）。四锚缝合带结构的极限拉伸强度显著大于四锚缝合线结构（平均差异：56.4N，p = 0.04）。缝合带和缝合线结构之间在间隙形成或刚度方面没有显著差异（p > 0.05）。
在三锚缝合桥修复中，缝合带比缝合线提供更大的加压肌腱-骨接触，而在四锚缝合桥结构中使用缝合带可获得更大的机械强度。
