Wang Jiang-Tao, Bu Jian-Li, Shen Xue-Zhen, Chang Han, Teng Li-Jia, Zhu Juan-Li, Liu Yang, Liu Yujie
Department of Orthopaedics, Chinese PLA General Hospital, Beijing 100853, China.
Zhongguo Gu Shang. 2021 May 25;34(5):442-7. doi: 10.12200/j.issn.1003-0034.2021.05.009.
To compare biomechanical characteristic of different high-strength sutures and suture sites for repairing posterior root tear of the medial meniscus with modified Mason-Allen technique.
Forty-eight specimen of medial meniscus of knee joint from fresh porcine (female, aged from 5 to 9 months with an average of 7 months) were chosen and established experimental model. The samples were divided into red zone fixation group and red-white zone fixation group according to suture sites, 24 in each group; and then were randomly divided into 3 subgroups which 8 in each group, and fixed with Ethibond suture, Ultrabraid suture and FiberWire suture, respectively. Biomechanical tests were performedon universal electromagnetic and mechanical testing machine. Each specimen was underwent 1 000 cyclic tests on the first time, then pull out test until failure. The maximum failure load, yield load, stiffness and displacement were analyzed.
All specimen were successfully completed biomechanical tests. The failure mode of Ethibond group was caused by suture fracture; 6 cases of Ultrabraid suture group was caused by suture fracture which belong to red zone fixation group, 10 cases were caused by suture pull out, which 2 cases belong to red zone fixation group, 8 cases belong to red-white zone fixation group;8 cases of FiberWire group was caused by suture pull-out. Biomechanical test showed that:(1)In terms of suture strength, comparison of the maximum failure load, yield load and stiffness showed that Ethibond suture group <Ultrabraid suture group <FiberWire suture group, and had statistical differences among groups (<0.05);comparison of cyclic displacement at 100, 500 and 1 000 cycles showed that Ethibond suturegroup>Ultrabraid suture group >FiberWire suture group, and had statistical differences among groups (<0.05);the results showed the suture strength in Ethibond was the best, Ultrabraid suture took the second place, and FiberWire suture was the worst. (2)As for different suture sites, comparison of the maximum failure load, yield load and stiffness showed that red zone fixation group >red-white region fixation group, and had statistical difference between two groups(< 0.05);comparison of cyclic displacement at 100, 500 and 1 000 cycles showed that red zone fixation group <red-white zone fixation group, and had statistical difference between two groups (<0.05);the results showed that suture strength in red zone fixation group was better than that of red white zone fixation group.
Mason-Allen suture could effectively fix posterior root tear of the medial meniscus and meet needs of early partial weight bearing after surgery. Suturing with Fiberwire in red zone is stronger and better for the meniscus healing and rehabilitation.
采用改良的梅森 - 艾伦技术，比较不同高强度缝线及缝合部位修复内侧半月板后根部撕裂的生物力学特性。
选取48个新鲜猪膝关节内侧半月板标本（雌性，年龄5至9个月，平均7个月），建立实验模型。样本根据缝合部位分为红区固定组和红白区固定组，每组24个；然后随机分为3个亚组，每组8个，分别用爱惜邦缝线、超强编织缝线和纤维线缝线进行固定。在万能电磁和机械试验机上进行生物力学测试。每个标本先进行1000次循环测试，然后进行拔出试验直至失效。分析最大失效载荷、屈服载荷、刚度和位移。
所有标本均成功完成生物力学测试。爱惜邦组的失效模式是缝线断裂；超强编织缝线组中，6例属于红区固定组，失效模式为缝线断裂，10例为缝线拔出，其中2例属于红区固定组，8例属于红白区固定组；纤维线组8例为缝线拔出。生物力学测试表明：（1）在缝线强度方面，最大失效载荷、屈服载荷和刚度的比较显示，爱惜邦缝线组<超强编织缝线组<纤维线缝线组，组间有统计学差异（<0.05）；100、500和1000次循环时的循环位移比较显示，爱惜邦缝线组>超强编织缝线组>纤维线缝线组，组间有统计学差异（<0.05）；结果表明爱惜邦缝线的缝线强度最佳，超强编织缝线次之，纤维线缝线最差。（2）对于不同的缝合部位，最大失效载荷、屈服载荷和刚度的比较显示，红区固定组>红白区固定组，两组间有统计学差异（<0.05）；100、500和1000次循环时的循环位移比较显示，红区固定组<红白区固定组，两组间有统计学差异（<0.05）；结果表明红区固定组的缝线强度优于红白区固定组。
梅森 - 艾伦缝线可有效固定内侧半月板后根部撕裂，满足术后早期部分负重的需求。在红区用纤维线缝合对半月板愈合及康复更强且更好。
