From the Department of Orthopedic Surgery, University of California Irvine (Dr. Chalmers and Dr. Scolaro); and Orthopaedic Biomechanics Laboratory, Congress Medical Foundation (Mr. Chung, Dr. McGarry, Dr. Lee).
J Am Acad Orthop Surg Glob Res Rev. 2024 Oct 21;8(10). doi: 10.5435/JAAOSGlobal-D-24-00194. eCollection 2024 Oct 1.
Adjunctive suture augmentation of patellar plate fixation has yet to be investigated. Our biomechanical study sought to evaluate whether suture augmentation improves dorsal patellar locking plate fixation. Our hypothesis was that suture augmentation would improve fixation of this construct.
A transverse patella fracture in six matched cadaveric pairs was stabilized using a patellar locking plate with or without suture augmentation. Specimens were tested at 60° knee flexion with load placed through quadriceps. Cyclic loading followed by load to failure was done. Stiffness, deformation at peak, and nonrecoverable deformation were calculated.
During cyclic loading, suture augmentation demonstrated a higher average stiffness throughout all loads. At the final cycle, deformation was markedly higher without suture augmentation. Average load to failure was higher with suture augmentation. Maximum load to failure occurred at 2500 N in both groups.
Suture augmentation in a transverse patellar fracture model improved dorsal plate fixation, leading to less fracture displacement at the final load. Although suture augmentation demonstrated higher stiffness and lower deformation, these trends were not statistically significant. In both groups, plate fixation sustained very high loads, which reflects the fixation strength of the dorsal locking plate and screw construct in this fracture model.
髌前板固定的辅助缝线增强尚未得到研究。我们的生物力学研究旨在评估缝线增强是否能改善背侧髌前板固定。我们的假设是缝线增强将改善这种结构的固定。
用髌前锁定板或髌前锁定板加缝线增强固定 6 对匹配的尸体膝关节横断性髌骨骨折。标本在 60°膝关节屈曲位，通过股四头肌加载。进行循环加载和失效负载测试。计算刚度、峰值变形和不可恢复变形。
在循环加载过程中，缝线增强在所有负载下均表现出更高的平均刚度。在最后一个循环中，没有缝线增强时变形明显更高。缝线增强组的平均失效负载更高。两组的最大失效负载均为 2500N。
在横向髌骨骨折模型中，缝线增强改善了背侧板固定，导致最终负载时骨折位移减少。尽管缝线增强表现出更高的刚度和更低的变形，但这些趋势没有统计学意义。在两组中，钢板固定都承受了非常高的负载，这反映了这种骨折模型中背侧锁定钢板和螺钉结构的固定强度。
