Inagaki Kenta, Ochiai Nobuyasu, Hashimoto Eiko, Hattori Fumiya, Hiraoka Yu, Ise Shohei, Shimada Yohei, Ohtori Seiji
Department of Orthopaedic Surgery, Chiba University Hospital, Chiba, Japan.
Orthop J Sports Med. 2023 Sep 8;11(9):23259671231196135. doi: 10.1177/23259671231196135. eCollection 2023 Sep.
Ulnar collateral ligament (UCL) injuries occur frequently in baseball players, and UCL reconstruction is performed when nonoperative treatment fails.
To compare a novel all-suture anchor method of UCL reconstruction with a method using bone tunnels (Ito method) by investigating the displacement against valgus torque and the failure strength.
Controlled laboratory study.
Eight fresh-frozen cadaveric upper extremities (mean age, 82.0 years) were utilized in this study. To evaluate the displacement against valgus torque, the valgus stability test was performed for 4 anterior oblique ligament (AOL) conditions: intact AOL, resected AOL, reconstructed using the anchor method, and reconstructed using the Ito method. The load-to-failure test was performed to evaluate the failure strength of the anchor and Ito methods. Displacement against valgus load was compared between conditions using the repeated-measures 2-way analysis of variance with Bonferroni post hoc test, and failure strength between the anchor and Ito methods was compared using the unpaired test.
Displacements of the intact AOL and anchor method were significantly greater than those of the resected AOL at both 60° and 90° of flexion (intact AOL: = .005 and < .001, respectively; and anchor method: = .024 and < .001, respectively). The displacement of the Ito method at 90° of flexion was significantly greater than that of the resected AOL ( .003), but no significant difference was observed at 60° of flexion ( .109). There were no significant differences in displacement between the anchor and Ito methods at any flexion angle, nor was there a significant difference in failure torque between the anchor and Ito methods (16.3 ± 3.1 vs 17.6 ± 2.3 N·m, respectively; = .537).
The displacement and failure strength against a valgus load after UCL reconstruction using a suture anchor on the ulnar side were equal to those using bone tunnels.
UCL reconstruction using a suture anchor on the ulnar side is simpler and less invasive than using bone tunnels, with similar outcomes.
尺侧副韧带（UCL）损伤在棒球运动员中频繁发生，当非手术治疗失败时需进行UCL重建。
通过研究抗外翻扭矩的位移和失效强度，比较一种新型全缝线锚定法UCL重建与使用骨隧道的方法（伊藤法）。
对照实验室研究。
本研究使用了8个新鲜冷冻的尸体上肢（平均年龄82.0岁）。为评估抗外翻扭矩的位移，对4种前斜韧带（AOL）情况进行外翻稳定性测试：完整AOL、切除AOL、使用锚定法重建和使用伊藤法重建。进行失效载荷测试以评估锚定法和伊藤法的失效强度。使用重复测量双向方差分析和Bonferroni事后检验比较不同情况下抗外翻载荷的位移，使用不成对t检验比较锚定法和伊藤法之间的失效强度。
在60°和90°屈曲时，完整AOL和锚定法的位移均显著大于切除AOL的位移（完整AOL：分别为P = 0.005和P < 0.001；锚定法：分别为P = 0.024和P < 0.001）。伊藤法在90°屈曲时的位移显著大于切除AOL的位移（P = 0.003），但在60°屈曲时未观察到显著差异（P = 0.109）。在任何屈曲角度下，锚定法和伊藤法之间的位移均无显著差异，锚定法和伊藤法之间的失效扭矩也无显著差异（分别为16.3±3.1与17.6±2.3 N·m；P = 0.537）。
尺侧使用缝线锚定进行UCL重建后，抗外翻载荷的位移和失效强度与使用骨隧道的情况相当。
尺侧使用缝线锚定进行UCL重建比使用骨隧道更简单、侵入性更小，且结果相似。
Zotero 插件
