Aliaj Klevis, Henninger Heath B, Tétreault-Paquin Jean-Olivier E, Getelman Mark H, Donahue Joseph P
Harold K. Dunn Orthopaedic Research Laboratory, Department of Orthopaedics, University of Utah, Salt Lake City, UT, USA.
Department of Bioengineering, University of Utah, Salt Lake City, UT, USA.
JSES Open Access. 2019 Apr 26;3(2):70-76. doi: 10.1016/j.jses.2019.02.002. eCollection 2019 Jul.
The purpose of this study was to evaluate the initial fixation of a transosseous-equivalent rotator cuff repair and an interlinked medial repair, quantifying the cyclic and failure loading properties of each construct.
Twenty-four human cadaveric shoulders from 12 matched pairs were dissected, and full-thickness supraspinatus tears were created. In each pair, 1 side was repaired with a transosseous-equivalent repair (control) and the other, with an interlinked repair. All specimens were cycled to 1 MPa of effective stress at 1 Hz for 500 cycles, and gap formation was recorded with a digital video system. All samples were then loaded to failure, and the ultimate load and displacement and modes of failure were recorded.
The interlinked repair showed a decrease in the amount of construct gapping after cycle 50 and in peak construct gapping compared with the control group (control, 3.4 ± 0.9 mm; interlinked, 2.5 ± 0.8 mm; = .048). The interlinked repair also showed a higher ultimate load to failure (control, 318.7 ± 77.9 N; interlinked, 420.6 ± 93.7 N; = .007). No other significant differences were detected between constructs for preparation or testing metrics.
The interlinked repair, in which 1 continuous suture linked the medial anchors, showed decreased construct gapping and increased ultimate load to failure compared with the control construct. This study establishes the biomechanical validity of the new interlinked repair construct compared with a previously validated construct.
本研究的目的是评估一种类似经骨的肩袖修复术和一种互连内侧修复术的初始固定情况,量化每种结构的循环加载特性和失效载荷特性。
对来自12对匹配供体的24个尸体肩部进行解剖,制造全层冈上肌撕裂。在每对中,一侧采用类似经骨的修复术(对照组)进行修复,另一侧采用互连修复术。所有标本在1Hz频率下循环加载至有效应力1MPa,持续500个循环,并用数字视频系统记录间隙形成情况。然后对所有样本进行加载直至失效,记录极限载荷、位移和失效模式。
与对照组相比,互连修复术在第50个循环后结构间隙量和最大结构间隙均有所减小(对照组为3.4±0.9mm;互连组为2.5±0.8mm;P = 0.048)。互连修复术的极限失效载荷也更高(对照组为318.7±77.9N;互连组为420.6±93.7N;P = 0.007)。在制备或测试指标方面,两种结构之间未检测到其他显著差异。
与对照结构相比,采用1根连续缝线连接内侧锚钉的互连修复术结构间隙减小,极限失效载荷增加。本研究证实了新的互连修复结构与先前验证的结构相比具有生物力学有效性。