Khoo John K, Lee Jae H T, Lam Patrick H, Wei Ai-Qun, Ronquillo Jonathan, Murrell George A C
Orthopaedic Research Institute, St. George Hospital Campus, University of New South Wales, Sydney, NSW, Australia.
JSES Open Access. 2019 Mar 11;3(1):29-36. doi: 10.1016/j.jses.2019.01.003. eCollection 2019 Mar.
Biodegradable suture anchors are associated with higher redislocation rates. This study examined whether the biocompatibility and/or biomechanical properties of suture anchors contribute to the increase in complications.
Human glenohumeral capsule cells were cultured with 4 types of suture anchors, Opus LabraFix (titanium alloy; ArthroCare, Austin, TX, USA), PushLock (poly-ether-ether-ketone; Arthrex, Naples, FL, USA), BioKnotless (poly-l-lactic acid; DePuy Mitek, Warsaw, IN, USA), and Suretac II (polyglycolic acid; Smith & Nephew, London, UK), to measure cell viability and pH. Four groups of 6 ovine shoulders were used to repair the labrum, which was completely detached from the glenoid rim anteroinferiorly and reattached with 2 suture anchors and subject to failure load testing.
In cell culture, BioKnotless at 48 and 72 hours (85.2% ± 2.1% and 84.5% ± 3.6%) and Suretac II groups (33.9% ± 3.1% and 42.8% ± 6.4%) had fewer viable cells compared with control ( = .048). The pH of Suretac II was lower than control (7.51 to 7.65) at 24 hours (7.31 ± 0.08, = .049), 48 hours (7.25 ± 0.02, = .046), and 72 hours (7.29 ± 0.04, = .04). During mechanical testing, 83% of repairs failed by the capsule tearing. Among the anchors, the BioKnotless repair group had a significantly lower failure load (37 ± 5 N) compared with the PushLock (61 ± 7 N), Opus (60 ± 6 N), and Suretac II (57 ± 7 N) groups ( = .038).
BioKnotless and Suretac II anchors are cytotoxic. The BioKnotless biodegradable anchor has significantly lower failure load. Absorbable suture anchors may cause higher redislocation of arthroscopic Bankart repair.
可生物降解的缝合锚钉与较高的再脱位率相关。本研究旨在探讨缝合锚钉的生物相容性和/或生物力学性能是否会导致并发症增加。
将人肩盂关节囊细胞与4种类型的缝合锚钉一起培养，分别是Opus LabraFix（钛合金；美国德克萨斯州奥斯汀市的ArthroCare公司）、PushLock（聚醚醚酮；美国佛罗里达州那不勒斯市的Arthrex公司）、BioKnotless（聚-L-乳酸；美国印第安纳州华沙市的DePuy Mitek公司）和Suretac II（聚乙醇酸；英国伦敦的施乐辉公司），以测量细胞活力和pH值。使用四组，每组6个羊肩来修复盂唇，将盂唇从肩胛盂边缘前下方完全分离，并用2个缝合锚钉重新固定，然后进行失效载荷测试。
在细胞培养中，与对照组相比，BioKnotless在48小时和72小时时（85.2%±2.1%和84.5%±3.6%）以及Suretac II组（33.9%±3.1%和42.8%±6.4%）的活细胞较少（P =.048）。Suretac II在24小时（7.31±0.08，P =.049）、48小时（7.25±0.02，P =.046）和72小时（7.29±0.04，P =.04）时的pH值低于对照组（7.51至7.65）。在力学测试中，83%的修复因关节囊撕裂而失败。在这些锚钉中，BioKnotless修复组的失效载荷（37±5 N）明显低于PushLock组（61±7 N）、Opus组（60±6 N）和Suretac II组（57±7 N）（P =.038）。
BioKnotless和Suretac II锚钉具有细胞毒性。BioKnotless可生物降解锚钉的失效载荷明显较低。可吸收缝合锚钉可能会导致关节镜下Bankart修复术后更高的再脱位率。
