Fang Chaohua, Cheng Rongshan, Jiang Jian, Dimitriou Dimitris, Wang Huizhi, Jiang Ziang, Tsai Tsung-Yuan, Cheng Cheng-Kung
Department of Sports Medicine, Ningbo No. 6 Hospital, Zhejiang, China.
School of Biomedical Engineering and Med-X Research Institute, Shanghai Jiao Tong University, Shanghai, China.
Front Surg. 2022 May 12;9:863823. doi: 10.3389/fsurg.2022.863823. eCollection 2022.
Several needleless techniques have been developed to outcome the inherent disadvantages of the traditional needle stitching technique for graft preparation, such as tendon damage through the needle, time consumption, and the potential risk of needlestick injury. The purpose of the present study is to compare the graft preparation time and the biomechanical performance between an efficient needleless technique and the traditional needle stitching technique for graft preparation in anterior cruciate ligament reconstruction (ACLR).
The time required to perform a complete suture on 20 hamstring tendons during ACLRs was measured. The grafts from one side were prepared using the needle stitching technique. The grafts from the other side used the needleless grasping suture technique. For the second part of the study, 12 fresh-frozen porcine flexor tendons were divided into two groups using two techniques and were mounted in an electric tensile test system. Each group was pretensioned to 100 N to simulate the maximum initial graft tension. The suturing state of sutures and graft (intact and damaged) and the load-elongation curve were recorded for each group. A Student's -test was used to compare the means of the two groups.
In operation, the needleless grasping suture technique group (19.8 ± 4.8, range: 13.5-32.9 s) was significantly faster ( < 0.05) than the needle stitching technique group (52.7 ± 12.7, range: 36.0-87.5 s). The state of sutures in each group was intact. The mean elongation was 11.75 ± 1.38 (range: 9.47-12.99) mm and 10.59 ± 1.02 (range: 9.12-11.76) mm in the needleless stitching technique group and the needle grasping suture technique group, respectively. There was no statistically significant difference in the elongation between the two groups ( > 0.05).
The needleless grasping suture technique was a convenient and efficient method for graft preparation in ACLR.
已开发出多种无针技术，以克服传统缝针技术在移植物制备过程中固有的缺点，如因缝针导致的肌腱损伤、耗时以及针刺伤的潜在风险。本研究的目的是比较在膝关节前交叉韧带重建（ACLR）中，一种高效无针技术与传统缝针技术在移植物制备时间和生物力学性能方面的差异。
测量了在ACLR过程中对20条腘绳肌腱进行完整缝合所需的时间。一侧的移植物采用缝针技术制备。另一侧的移植物采用无针抓持缝合技术。在研究的第二部分，将12条新鲜冷冻的猪屈肌腱用两种技术分为两组，并安装在电动拉伸试验系统中。每组均预加载至100 N以模拟移植物的最大初始张力。记录每组缝线和移植物的缝合状态（完整和受损）以及载荷-伸长曲线。采用学生t检验比较两组的均值。
手术中，无针抓持缝合技术组（19.8±4.8，范围：13.5 - 32.9 s）明显比缝针技术组（52.7±12.7，范围：36.0 - 87.5 s）快（<0.05）。每组缝线状态均完整。无针缝合技术组和抓持缝合技术组的平均伸长量分别为11.75±1.38（范围：9.47 - 12.99） mm和10.59±1.02（范围：9.12 - 11.76） mm。两组之间的伸长量无统计学显著差异（>0.05）。
无针抓持缝合技术是ACLR中一种方便且高效的移植物制备方法。
