Department of Trauma and Orthopedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
UKE Athleticum-Center for Athletic Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Knee Surg Sports Traumatol Arthrosc. 2023 Jan;31(1):161-168. doi: 10.1007/s00167-022-06929-0. Epub 2022 Mar 22.
Biomechanical evaluation of three different suture button devices used in acromioclavicular joint repair and analysis of their effect on post-testing tunnel widening.
Eighteen human shoulder girdles were assigned into three groups with a similar mean bone mineral density. Three different single-tunnel acromioclavicular repair devices were tested: (1) AC TightRope with FiberWire; (2) AC Dog Bone Button with FiberTape; (3) Low Profile AC Repair System. Biomechanical testing was performed simulating the complex movement of the distal clavicle as follows. A vertical load of 80 N was applied continuously. The rotation of the clavicle about its long axis was set at 10° anterior and 30° posterior for 2500 cycles at 0.25 Hz. The horizontal translation of the clavicle was set at 6 mm medial and 6 mm lateral for 10,000 cycles at 1 Hz. The coracoclavicular distance was measured before and after testing. After testing, each sample underwent micro-CT analysis. Following 3D reconstruction, the area of the bone tunnels was measured at five defined cross sections.
In TightRope and Dog Bone groups, all samples completed testing, whereas in the Low Profile group, three out of six samples showed system failure. The mean absolute difference of coracoclavicular distance after testing was significantly greater in the Low Profile group compared to TightRope and Dog Bone groups (4.3 ± 1.3 mm vs 1.9 ± 0.7 mm vs 1.9 ± 0.8 mm; p = 0.001). Micro-CT analysis of the specimens demonstrated significant tunnel widening in the inferior clavicular and superior coracoid regions in all three groups (p < 0.05).
Significant tunnel widening can be observed for all devices and is primarily found in the inferior parts of the clavicle and superior parts of the coracoid. The Low Profile AC Repair System showed inferior biomechanical properties compared to the AC TightRope and AC Dog Bone devices. Therefore, clinicians should carefully select the type of acromioclavicular repair device used and need to consider tunnel widening as a complication.
生物力学评价三种不同的缝线纽扣装置在肩锁关节修复中的应用，并分析其对术后隧道增宽的影响。
将 18 个人体肩带分为三组，每组具有相似的平均骨密度。测试了三种不同的单隧道肩锁关节修复装置：（1）AC TightRope 与 FiberWire；（2）AC Dog Bone Button 与 FiberTape；（3）Low Profile AC Repair System。生物力学测试模拟了锁骨远端的复杂运动，具体如下。持续施加 80N 的垂直载荷。锁骨绕其长轴的旋转角度设定为前 10°和后 30°，频率为 0.25Hz，循环 2500 次。锁骨的水平平移设定为内侧 6mm 和外侧 6mm，频率为 1Hz，循环 10000 次。测试前后测量喙锁间距。测试后，每个样本进行微 CT 分析。三维重建后，在五个定义的横截面测量骨隧道的面积。
在 TightRope 和 Dog Bone 组中，所有样本均完成了测试，而在 Low Profile 组中，6 个样本中有 3 个出现系统故障。与 TightRope 和 Dog Bone 组相比，Low Profile 组测试后喙锁间距的平均绝对差值明显更大（4.3±1.3mm 比 1.9±0.7mm 比 1.9±0.8mm；p=0.001）。对标本的微 CT 分析表明，所有三组均在锁骨下和喙骨上区域出现明显的隧道增宽（p<0.05）。
所有装置均可观察到明显的隧道增宽，主要发生在锁骨的下部和喙骨的上部。与 AC TightRope 和 AC Dog Bone 装置相比，Low Profile AC Repair System 显示出较差的生物力学性能。因此，临床医生应仔细选择使用的肩锁关节修复装置的类型，并需要考虑隧道增宽作为一种并发症。
