Fowler Kennedy Sports Medicine Clinic, 3M Center, Western University, London Ontario, Canada.
Lawson Health Research Institute, Mechanical and Materials Engineering, Western University, London Ontario, Canada.
Arthroscopy. 2020 Aug;36(8):2260-2267. doi: 10.1016/j.arthro.2020.04.020. Epub 2020 Apr 28.
To compare the biomechanical differences between quadriceps tendon (QT) repair with high-strength suture (HSS) versus suture tape (ST) with varying number of suture passes.
In total, 28 fresh-frozen QTs were randomized into 2 groups: (1) HSS; or (2) ST; specimens were then further randomized into subgroups of either 4 or 6 suture passes. Specimens were secured within a materials testing system and a 150-N preload was applied for 10 seconds followed by a cyclic loading protocol between 50 N and 250 N for 1000 cycles. Video was used to follow tracking markers used to calculate the magnitude of tendon displacement. Two-way univariate analysis of variance was used to determine the effect of suture type and passes on the displacement after preloading and mixed repeated-measures analysis of variance was used to determine the effect of suture type and passes on displacement following cyclic loading.
There were large increases in displacement following the preload across all conditions (7.82 ± 3.64 mm), with no statistically significant differences between groups. There was a significant difference in the mean (± standard deviation) displacement between the ST (5.24 ± 2.82 mm) and HSS (7.93 ± 2.91 mm) starting at 200 cycles, which became more pronounced with successive testing out to 1000 cycles (P = .021). There were no significant difference with respect to the number of suture or tape passes.
Following preloading at 150 N, significant displacement occurred in both QT repair groups. ST demonstrated significantly less displacement than HSS under cyclic loading and had greater ultimate failure loads.
When performing QT repair, emphasis should be placed on appropriate pretensioning of sutures to at least 150 N before knot-tying. In addition, where available, ST should be used over HSS to reduce further cyclic elongation and improve ultimate failure loads.
比较使用高强度缝线（HSS）与缝线带（ST）修复股四头肌腱（QT）时，不同缝线穿过数量的生物力学差异。
总共 28 个新鲜冷冻的 QT 随机分为 2 组：（1）HSS；或（2）ST；标本随后进一步随机分为 4 或 6 缝线穿过的亚组。标本被固定在材料测试系统中，并施加 150N 的预载 10 秒，然后进行 50N 至 250N 的循环加载方案 1000 次。视频用于跟踪用于计算肌腱位移量的标记。使用双向单变量方差分析来确定缝线类型和穿过数量对预加载后的位移的影响，使用混合重复测量方差分析来确定缝线类型和穿过数量对循环加载后位移的影响。
所有条件下的预载后位移均有较大增加（7.82 ± 3.64mm），但组间无统计学差异。在 200 次循环后，ST（5.24 ± 2.82mm）和 HSS（7.93 ± 2.91mm）之间的平均（±标准偏差）位移存在显著差异，随着连续测试至 1000 次循环，差异变得更加明显（P =.021）。缝线或带穿过的数量没有显著差异。
在 150N 的预加载后，QT 修复的两组均发生明显位移。在循环加载下，ST 比 HSS 显示出明显较小的位移，并且具有更大的最终失效负荷。
在进行 QT 修复时，应在打结前至少将缝线预张紧至 150N。此外，在可用的情况下，应使用 ST 代替 HSS，以减少进一步的循环伸长并提高最终失效负荷。
