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两种高强缝线的肩袖肌腱组织切割-through 比较。

Rotator cuff tendon tissue cut-through comparison between 2 high-tensile strength sutures.

机构信息

Department of Orthopaedic Surgery, Warren Alpert School of Medicine, Brown University, Providence, RI, USA.

DePuy Synthes Mitek Sports Medicine, Raynham, MA, USA.

出版信息

J Shoulder Elbow Surg. 2019 Oct;28(10):1897-1902. doi: 10.1016/j.jse.2019.02.028. Epub 2019 May 10.

Abstract

BACKGROUND

High-tensile strength sutures are known to cut through tendon tissue when used for rotator cuff and other tendon repairs, resulting in mechanical failure. The purpose of this study was to test a new suture and compare it with an established suture in a controlled laboratory setting.

METHODS

Two sutures, Dynacord and FiberWire, both USP size No. 2, were passed through fresh infraspinatus tendons from 7 matched pairs of ovine shoulders (14 shoulders). Samples underwent cyclic testing for 1000 cycles, and the amount of cheese-wire tissue damage (tendon cut-through) was recorded. A clinical failure was defined as greater than 5 mm of tissue cut-through.

RESULTS

The mean amount of tendon cut-through was 3.72 ± 1.14 mm in the FiberWire specimens and 2.69 ± 1.02 mm in the Dynacord group. The difference was statistically significant (P = .012). In the matched-pair analysis, more tendon cut-through was noted with FiberWire in 13 specimens whereas a greater amount was found in only 1 Dynacord specimen. The FiberWire specimens showed 2 instances of tissue tendon cut-through exceeding 5 mm, defined as a clinical failure.

CONCLUSIONS

In this cadaveric ovine rotator cuff tendon model, we found less tendon cut-through from Dynacord suture compared with FiberWire. In addition, 2 of the FiberWire specimens showed complete tendon cut-through. Future studies focusing on patient-reported outcomes and healing rates with different types of suture materials are needed.

摘要

背景

在进行肩袖和其他肌腱修复时,高强度缝线已知会割穿肌腱组织,导致机械故障。本研究的目的是测试一种新缝线,并在受控的实验室环境中将其与已建立的缝线进行比较。

方法

将两种缝线,Dynacord 和 FiberWire,均为 USP 2 号大小,穿过来自 7 对匹配羊肩(14 个肩膀)的新鲜冈下肌腱。样本进行了 1000 次循环测试,记录奶酪线组织损伤(肌腱割穿)的数量。临床失败定义为超过 5 毫米的组织割穿。

结果

在 FiberWire 标本中,肌腱割穿的平均量为 3.72 ± 1.14 毫米,而在 Dynacord 组中为 2.69 ± 1.02 毫米。差异具有统计学意义(P =.012)。在配对分析中,13 个标本中纤维丝的肌腱割穿量更多,而 Dynacord 只有 1 个标本中发现更多的肌腱割穿量。FiberWire 标本中有 2 个标本的组织肌腱割穿量超过 5 毫米,定义为临床失败。

结论

在这个羊的尸体肩袖肌腱模型中,我们发现 Dynacord 缝线的肌腱割穿量比 FiberWire 缝线少。此外,2 个 FiberWire 标本显示完全的肌腱割穿。需要进行未来的研究,重点关注不同类型缝线材料的患者报告结果和愈合率。

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