带内支撑增强的尺侧副韧带修复对关节接触力学的影响：一项尸体研究。
The Effect of Ulnar Collateral Ligament Repair With Internal Brace Augmentation on Articular Contact Mechanics: A Cadaveric Study.
作者信息
Roth Travis S, Beason David P, Clay T Bradley, Cain E Lyle, Dugas Jeffrey R
机构信息
American Sports Medicine Institute, Birmingham, Alabama, USA.
Andrews Sport Medicine and Orthopaedic Center, Birmingham, Alabama, USA.
出版信息
Orthop J Sports Med. 2021 Apr 23;9(4):23259671211001069. doi: 10.1177/23259671211001069. eCollection 2021 Apr.
BACKGROUND
There has been renewed interest in ulnar collateral ligament (UCL) repair in throwing athletes because of a greater understanding of UCL injuries, improvement in ligament repair technology, and potentially expedited rehabilitation time and return to play relative to UCL reconstruction.
PURPOSE
To evaluate elbow articular contact and overall joint torque after UCL reconstruction and repair augmented with a collagen-coated fiber tape, InternalBrace.
STUDY DESIGN
Controlled laboratory study.
METHODS
Ten matched pairs of cadaveric arms (mean age, 41 ± 11 years) were dissected to expose the UCL. Each specimen was secured into a custom test fixture at 90°, and 1 specimen from each pair underwent either a modified Jobe UCL reconstruction or UCL repair with InternalBrace. Each specimen underwent 10 cycles of elbow valgus angular displacement between 0° and 5° at a rate of 1 deg/s in the intact state, after UCL avulsion, and then after UCL reconstruction or repair. Articular contact mechanics and overall joint torque and stiffness were recorded.
RESULTS
Contact mechanics of reconstructed and repaired specimens were not significantly different. Both reconstruction and repair procedures returned the overall resistance of the joint to valgus torsion to near-intact levels. UCL repair tended to restore joint torque more closely to the intact state than did reconstruction, given that reconstruction showed a nonsignificant trend toward lower torque than the intact state ( = .07).
CONCLUSION
Neither UCL reconstruction nor UCL repair with InternalBrace overconstrained the elbow joint, as both groups had similar contact pressures compared with the native joint. Both procedures also restored elbow joint torque and stiffness to levels not statistically different from the intact state.
CLINICAL RELEVANCE
Given the sound biomechanical properties of UCL repair with InternalBrace, it may have a significant role as treatment for UCL injuries.
背景
由于对尺侧副韧带（UCL）损伤有了更深入的了解、韧带修复技术有所改进，且相对于UCL重建而言，康复时间可能会加快并能更快重返赛场，因此投掷运动员的UCL修复再次引起了人们的关注。
目的
评估使用胶原涂层纤维带InternalBrace增强的UCL重建和修复术后的肘关节面接触及整体关节扭矩。
研究设计
对照实验室研究。
方法
解剖10对匹配的尸体手臂（平均年龄41±11岁）以暴露UCL。将每个标本固定在90°的定制测试夹具中，每对中的1个标本接受改良的乔布UCL重建或使用InternalBrace进行UCL修复。每个标本在完整状态下、UCL撕脱后以及UCL重建或修复后，以1度/秒的速度在0°至5°之间进行10个周期的肘关节外翻角位移。记录关节面接触力学、整体关节扭矩和刚度。
结果
重建和修复标本的接触力学无显著差异。重建和修复手术均使关节对外翻扭转的整体抵抗力恢复到接近完整水平。与重建相比，UCL修复倾向于使关节扭矩更接近完整状态，因为重建显示出扭矩低于完整状态的趋势不显著（P = 0.07）。
结论
UCL重建和使用InternalBrace进行的UCL修复均未过度限制肘关节，因为与天然关节相比，两组的接触压力相似。两种手术还将肘关节扭矩和刚度恢复到与完整状态无统计学差异的水平。
临床意义
鉴于使用InternalBrace进行UCL修复具有良好的生物力学特性，它可能在UCL损伤的治疗中发挥重要作用。
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