使用金属锚钉与全缝线锚钉进行喙锁固定的生物力学比较
Biomechanical Comparison of Coracoclavicular Fixation Using Metallic Versus All-Suture Anchors.
作者信息
Hong Chih-Kai, Kuan Fa-Chuan, Hsu Kai-Lan, Chen Yueh, Chiang Chen-Hao, Su Wei-Ren
机构信息
Department of Orthopaedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Department of Orthopaedic Surgery, Kaohsiung Veterans General Hospital Tainan Branch, Tainan, Taiwan.
出版信息
Orthop J Sports Med. 2024 Jan 24;12(1):23259671231222505. doi: 10.1177/23259671231222505. eCollection 2024 Jan.
BACKGROUND
A coracoclavicular (CC) fixation technique using an all-suture anchor with the assistance of fluoroscopy can prevent iatrogenic anterior deltoid detachment from the clavicle; however, soft anchor pullout has been reported as a complication.
PURPOSE
To compare the biomechanical properties of conventional metallic and all-suture anchors for CC suture fixation.
STUDY DESIGN
Controlled laboratory study.
METHODS
A total of 24 fresh-frozen cadaveric specimens were divided into 2 groups: metal anchor group (group M) and all-suture anchor group (group A). In group M, 5.0-mm metallic suture anchors were used for CC fixation, whereas 2.8-mm all-suture anchors were used in group A. The prepared specimens were mounted on a materials testing machine. After preconditioning at 0 to 20 N for 10 cycles, the specimens were subjected to cyclic loading from 20 to 70 N for 1000 cycles. Finally, all the specimens were loaded to failure. Cyclic elongation, linear stiffness, ultimate load, and failure modes were recorded, and the Mann-Whitney test was used to compare nonparametric parameters between the 2 groups.
RESULTS
All of the specimens completed the cyclic loading test. The elongation after cyclic loading in group M (1.6 ± 0.6 mm) was significantly smaller compared with that in group A (2.5 ± 1.2 mm) ( = .02). No between-group differences were found in linear stiffness (42 ± 17 N/mm in group M and 41 ± 17 N/mm in group A). The ultimate failure load in group M (263 ± 66 N) was significantly greater than that in group A (177 ± 76 N) ( = .02). All specimens failed because of suture anchor pullout.
CONCLUSION
The use of all-suture anchors in CC fixation resulted in significantly greater cyclic displacement and smaller ultimate failure load than that of metallic anchors.
CLINICAL RELEVANCE
Understanding the most biomechanically sound suture anchor may assist in lowering the risk of clinical failure in CC fixation and repair.
背景
一种在透视辅助下使用全缝线锚钉的喙锁（CC）固定技术可防止医源性肩前三角肌从锁骨上分离；然而，有报道称软锚钉拔出是一种并发症。
目的
比较传统金属锚钉和全缝线锚钉用于CC缝线固定的生物力学特性。
研究设计
对照实验室研究。
方法
将24个新鲜冷冻尸体标本分为2组：金属锚钉组（M组）和全缝线锚钉组（A组）。M组使用5.0毫米金属缝线锚钉进行CC固定，而A组使用2.8毫米全缝线锚钉。将制备好的标本安装在材料试验机上。在0至20牛的预加载条件下循环加载10次后，标本承受从20至70牛的循环加载1000次。最后，对所有标本进行加载直至破坏。记录循环伸长、线性刚度、极限载荷和破坏模式，并使用曼-惠特尼检验比较两组间的非参数参数。
结果
所有标本均完成循环加载试验。M组循环加载后的伸长量（1.6±0.6毫米）明显小于A组（2.5±1.2毫米）（P = 0.02）。两组间线性刚度无差异（M组为42±17牛/毫米，A组为41±17牛/毫米）。M组的极限破坏载荷（263±66牛）明显大于A组（177±76牛）（P = 0.02）。所有标本均因缝线锚钉拔出而破坏。
结论
在CC固定中使用全缝线锚钉比金属锚钉导致更大的循环位移和更小的极限破坏载荷。
临床意义
了解生物力学性能最佳的缝线锚钉可能有助于降低CC固定和修复的临床失败风险。
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