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全缝线锚钉在人体肩大结节的循环和失效负载特性。

Cyclic and Load-to-Failure Properties of All-Suture Anchors in Human Cadaveric Shoulder Greater Tuberosities.

机构信息

Department of Orthopaedics, Columbia University, New York, New York, U.S.A.

Department of Orthopaedic Surgery, Atrium Health, Charlotte, North Carolina, U.S.A.

出版信息

Arthroscopy. 2020 Nov;36(11):2805-2811. doi: 10.1016/j.arthro.2020.06.010. Epub 2020 Jun 15.

Abstract

PURPOSE

The purpose of this study was to evaluate the cyclic displacement, stiffness, and ultimate load to failure of 3 all-suture anchors in human cadaveric greater tuberosities.

METHODS

Three all-suture anchors indicated for rotator cuff repair were tested in 14 matched pairs of human cadaver fresh-frozen humeri. Anchors were inserted at 3 locations from anterior to posterior along the greater tuberosity and placed 5 mm from the articular margin. The constructs were cycled from 10 to 60 N at 1 Hz for 200 cycles. The anchors that survived cycling were then subjected to a single pull to failure test. A Kruskal-Wallis 1-way analysis of variance on ranks was performed to compare the displacement, stiffness, and ultimate load to failure of the different anchors tested.

RESULTS

One matched pair was excluded because of poor bone quality; therefore, 13 matched pairs were included in the study. After 20, 100, and 200 cycles, there was no difference in median displacement between the anchors tested (P = .23, P = .21, P = .18, respectively). The median ultimate load-to-failure between the Iconix (295.2 N, 95% confidence interval [CI], 125-762.2), JuggerKnot (287.6 N, 95% CI, 152.9-584.4), and Q-fix (333.3 N, 95% CI, 165.0-671.9) showed no statistically significant difference (P = .58). After 20, 100, and 200 cycles, there was no difference in median stiffness between the anchors tested (P = .41, P = .19, P = .26 respectively). Displacement greater than 5 mm occurred in 0 Iconix anchors (0%), 1 JuggerKnot anchor (3.64%), and 2 Q-fix anchors (7.69%). One JuggerKnot anchor failed by anchor pullout during cyclic loading.

CONCLUSIONS

When tested in human cadaveric humeral greater tuberosities 3 all-suture anchors, the 2.9-mm JuggerKnot, the 2.8-mm Q-fix, and the 2.3-mm Iconix, showed no significant differences in median displacement or stiffness after 20, 100, or 200 cycles or in median ultimate load to failure. Although not statistically significant, the Iconix was the only anchor tested to have no failures, whereas the JuggerKnot had both a clinical and catastrophic failure and the Q-fix had 2 clinical failures.

LEVEL OF EVIDENCE

Level V, Controlled Laboratory Study.

摘要

目的

本研究旨在评估 3 种全缝线锚钉在前盂唇到后盂唇不同位置固定时的循环位移、刚度和极限失效负荷。

方法

本研究纳入了 14 对经新鲜冷冻处理的人肱骨头尸体,将 3 种全缝线锚钉分别于前盂唇到后盂唇 3 个位置、距关节面 5mm 处进行固定。所有锚钉在循环加载机上以 1Hz 的频率进行 10-60N 的循环加载,共 200 个循环。循环加载后,锚钉进行单轴拉伸失效测试。采用 Kruskal-Wallis 1 路方差分析比较不同锚钉的位移、刚度和极限失效负荷。

结果

由于骨质量较差,1 对配对肱骨头被排除在外,最终有 13 对配对肱骨头纳入研究。在经过 20、100 和 200 个循环后,3 种锚钉的位移无统计学差异(P=0.23,P=0.21,P=0.18)。Iconix(295.2N,95%置信区间:125-762.2N)、JuggerKnot(287.6N,95%置信区间:152.9-584.4N)和 Q-fix(333.3N,95%置信区间:165.0-671.9N)锚钉的极限失效负荷也无统计学差异(P=0.58)。在经过 20、100 和 200 个循环后,3 种锚钉的刚度也无统计学差异(P=0.41,P=0.19,P=0.26)。0 个 Iconix 锚钉(0%)、1 个 JuggerKnot 锚钉(3.64%)和 2 个 Q-fix 锚钉(7.69%)发生超过 5mm 的位移。1 个 JuggerKnot 锚钉在循环加载时发生锚钉拔出失效。

结论

在对人肱骨头尸体进行的研究中,2.9mm 的 JuggerKnot、2.8mm 的 Q-fix 和 2.3mm 的 Iconix 全缝线锚钉在前盂唇到后盂唇不同位置固定时,在经过 20、100 或 200 个循环后,在位移或刚度方面无显著差异,极限失效负荷也无显著差异。虽然没有统计学意义,但 Iconix 是唯一没有失效的锚钉,而 JuggerKnot 出现了 1 例临床失败和 1 例灾难性失败,Q-fix 出现了 2 例临床失败。

证据等级

5 级,对照实验室研究。

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