Hong Chih-Kai, Su Wei-Ren, Kuan Fa-Chuan, Chen Yueh, Chiang Chen-Hao, Hsu Kai-Lan
Department of Orthopaedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan.
Skeleton Materials and Bio-compatibility Core Lab, Research Center of Clinical Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan.
Arthrosc Sports Med Rehabil. 2020 Oct 15;2(6):e795-e801. doi: 10.1016/j.asmr.2020.07.018. eCollection 2020 Dec.
To compare the biomechanical properties of high-tensile strength tape and a high-tensile strength suture in subpectoral biceps tenodesis using a suture anchor in a porcine tendon model.
A total of 24 artificial composite (polymer and glass fiber) humeri and porcine flexor profundus tendons were used. Two types of suture materials, high-tensile strength sutures (group S) and high-tensile strength tapes (group T), were evaluated. After we inserted metallic suture anchors with either 2 sutures or tapes 5 cm from the superomedial corner of the greater tuberosity, a Krackow suture technique was used to secure the tendons. After a preload of 5 N for 2 minutes, a cyclic loading test from 5 to 70 N was conducted for 500 cycles. Finally, the specimen was loaded to failure at a rate of 1 mm/s.
There were no significant between-group differences in elongation after cyclic loading and elongation at failure load for group S and group T ( = .977 and .630, respectively). The ultimate failure loads in group T (278.2 ± 54 N) were significantly greater than those in group S (249.4 ± 32 N) ( = .028). In contrast, the stiffness values in group T (28.5 ± 4.0 N/mm) were significantly lower than those in group S (32.3 ± 4.5 N) ( = .028). Ten specimens in group S and 8 specimens in group T failed, with tendons being cut through by the sutures, whereas the other 2 specimens in group S and 4 specimens in group T failed due to suture breakage.
Using high-tensile strength tapes in subpectoral biceps tenodesis using a suture anchor leads to significantly greater ultimate failure load as compared with using high-tensile strength sutures in a porcine model. Although lower levels of stiffness were found in high-tensile strength tape group, the difference in the means were not large between 2 groups.
A strong suture-tendon structure may prevent clinical failure of a subpectoral biceps tenodesis using a suture anchor.
在猪肌腱模型中，使用缝合锚钉比较胸大肌下肱二头肌肌腱固定术中高强度胶带和高强度缝线的生物力学性能。
总共使用了24个人造复合（聚合物和玻璃纤维）肱骨及猪的指深屈肌腱。评估了两种缝合材料，即高强度缝线（S组）和高强度胶带（T组）。在从大结节的上内侧角5厘米处插入带有2根缝线或胶带的金属缝合锚钉后，采用Krackow缝合技术固定肌腱。在5 N的预负荷下持续2分钟后，进行从5至70 N的循环加载试验，共500个循环。最后，以1 mm/s的速率对标本加载直至破坏。
S组和T组在循环加载后的伸长率以及破坏载荷下的伸长率方面，组间差异均无统计学意义（分别为P = 0.977和P = 0.630）。T组的极限破坏载荷（278.2±54 N）显著高于S组（249.4±32 N）（P = 0.028）。相反，T组的刚度值（28.5±4.0 N/mm）显著低于S组（32.3±4.5 N）（P = 0.028）。S组有10个标本和T组有8个标本发生破坏，肌腱被缝线切断，而S组的另外2个标本和T组的4个标本因缝线断裂而破坏。
在猪模型中，在胸大肌下肱二头肌肌腱固定术中使用高强度胶带与使用高强度缝线相比，可导致显著更高的极限破坏载荷。尽管高强度胶带组的刚度水平较低，但两组之间的均值差异不大。
牢固的缝线-肌腱结构可能会防止使用缝合锚钉的胸大肌下肱二头肌肌腱固定术出现临床失败。
