Department of Biomedical Engineering, Asan Medical Center, Asan Medical Institute of Convergence Science and Technology, University of Ulsan College of Medicine, Pungnap2-dong, Songpa-gu, Seoul, South Korea.
Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-Ro 43-Gil Songpa-Gu, Seoul, 05505, South Korea.
Sci Rep. 2023 Nov 28;13(1):20976. doi: 10.1038/s41598-023-48392-y.
Conventional suture anchors (CAs) and all-suture anchors (ASAs) are used for rotator cuff repair. Pull-out strength (POS) is an important factor that affects surgical outcomes. While the fixation mechanism differs between the anchor types and relies on the quality, few studies have compared biomechanical properties of anchors based on bone quality. This study aimed to compare the biomechanical properties of anchors using osteoporotic bone (OB) and non-osteoporotic bone (NOB) simulators. Humerus simulators were fabricated using fused deposition modeling of 3D printing and acrylonitrile butadiene styrene adjusting the thickness of cortical bone and density of cancellous bone based on CT images. Cyclic loading from 10 to 50 N, 10 to 100 N, and 10 to 150 N for 10 cycles was clinically determined at each anchor because the supraspinatus generates a force of 67-125 N in daily activities of normal control. After cyclic loading, the anchor was extruded at a load of 5 mm/min. Displacement, POS, and stiffness were measured. In OB simulators, CAs revealed bigger gap displacement than ASAs with cyclic loading of 10-150 N. ASA showed higher values for POS and stiffness. In NOB simulators, ASAs revealed bigger gap displacement than CAs with cyclic loading of 10-150 N. ASA showed higher values for POS and CA showed higher values for stiffness. POS of anchors depends on anchors 'displacement and bone stiffness. In conclusion, ASA demonstrated better biomechanical performance than CA in terms of stability under cyclic loading and stiffness with similar POS in OB.
传统缝合锚（CA）和全缝线锚（ASA）用于肩袖修复。拔出强度（POS）是影响手术效果的重要因素。虽然锚的固定机制因锚的类型而异，取决于质量，但很少有研究根据骨质量比较锚的生物力学特性。本研究旨在比较使用骨质疏松骨（OB）和非骨质疏松骨（NOB）模拟器的锚的生物力学特性。使用 3D 打印的熔融沉积建模制造肱骨模拟器，并根据 CT 图像调整皮质骨的厚度和松质骨的密度来制造丙烯腈丁二烯苯乙烯。由于在正常对照组的日常活动中，肩袖上旋肌产生的力为 67-125N，因此临床确定每个锚点在 10-50N、10-100N 和 10-150N 之间进行 10 个循环的循环加载。在循环加载后，以 5mm/min 的负载将锚挤出。测量位移、POS 和刚度。在 OB 模拟器中，与 10-150N 的循环加载相比，CA 显示出比 ASA 更大的间隙位移。ASA 表现出更高的 POS 和刚度值。在 NOB 模拟器中，与 10-150N 的循环加载相比，ASA 显示出比 CA 更大的间隙位移。ASA 表现出更高的 POS 和 CA 表现出更高的刚度值。锚的 POS 取决于锚的位移和骨刚度。总之，与 CA 相比，ASA 在 OB 中具有相似的 POS 时，在循环加载下的稳定性和刚度方面表现出更好的生物力学性能。
