Sasaki Shizuka, Yamauchi Shohei, Sasaki Eiji, Kimura Yuka, Takahashi Akane, Ishibashi Yasuyuki
Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
Arthrosc Sports Med Rehabil. 2022 Feb 1;4(2):e387-e392. doi: 10.1016/j.asmr.2021.08.019. eCollection 2022 Apr.
To compare the initial fixation strength of osteochondral fragment fixations using osteochondral plugs, bioabsorbable pins, and knotless suture anchors.
Eighteen fresh-frozen immature (6 month old) porcine knees were used. An osteochondral fragment, cut from the articular surface of the medial femoral condyle to achieve a thickness of 5 mm, was used to mimic the unstable osteochondral fragment. It was fixed using three techniques, including two osteochondral plugs (osteochondral plug group), four full-threaded poly l-lactic acid pins (bioabsorbable pin group), and three suture anchors with a 2-0 tape (suture anchor group). Tensile loads at displacements of 1 and 2 mm and ultimate failure load were measured at a cross-head speed of 100 mm/min, and the variables of the three groups were compared statistically using a one-way ANOVA with Tukey's honestly significant difference test.
There was no significant difference in the tensile load to achieve 1-mm displacement. The load to achieve 2-mm displacement and the ultimate failure load were significantly greater in the suture anchor group than the osteochondral plug group and the bioabsorbable pin group.
Single-pull destructive testing of a fixed articular osteochondral fragment with the force perpendicular to the articular surface, demonstrated no statistical difference in the tensile load to achieve 1-mm displacement, but the load to achieve 2-mm displacement was significantly greater for the three suture anchor-interlocking 2-0 tape constructs than the dual osteochondral plug fixation and the four bioabsorbable pin fixation constructs. Additionally, the three suture anchor-interlocking 2-0 tape construct's mean single-pull failure load was greater than other two fixation procedures.
To achieve osteochondral fragment union, sufficient fixation strength is critical. However, the initial fixation strength of osteochondral plugs, bioabsorbable pins, and knotless suture anchors for unstable osteochondral lesions remains unclear.
比较使用骨软骨栓、生物可吸收钉和无结缝线锚钉进行骨软骨碎片固定的初始固定强度。
使用18个新鲜冷冻的未成熟（6个月大）猪膝关节。从股骨内侧髁关节面切下一个厚度为5毫米的骨软骨碎片，用于模拟不稳定的骨软骨碎片。采用三种技术进行固定，包括两个骨软骨栓（骨软骨栓组）、四个全螺纹聚左旋乳酸钉（生物可吸收钉组）和三个带2-0带线的缝线锚钉（缝线锚钉组）。在十字头速度为100毫米/分钟的情况下，测量位移为1毫米和2毫米时的拉伸载荷以及极限破坏载荷，并使用单因素方差分析和Tukey真实显著性差异检验对三组变量进行统计学比较。
在实现1毫米位移的拉伸载荷方面，没有显著差异。在实现2毫米位移的载荷和极限破坏载荷方面，缝线锚钉组显著高于骨软骨栓组和生物可吸收钉组。
对固定的关节骨软骨碎片进行垂直于关节面的单拉破坏试验表明，在实现1毫米位移的拉伸载荷方面没有统计学差异，但对于三种缝线锚钉-联锁2-0带线结构，实现2毫米位移的载荷显著高于双骨软骨栓固定和四个生物可吸收钉固定结构。此外，三种缝线锚钉-联锁2-0带线结构的平均单拉破坏载荷大于其他两种固定方法。
为实现骨软骨碎片愈合，足够的固定强度至关重要。然而，对于不稳定的骨软骨损伤，骨软骨栓、生物可吸收钉和无结缝线锚钉的初始固定强度仍不清楚。
