Yang Yi-Tao, Su Yun, Wang Zhuo, Zhang Jin-Ming, Long Yi, Meng Chen-Yang, Deng Xing-Hao, Hou Jing-Yi, Yang Rui
Department of Sports Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.
Department of Imaging Department, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.
BMC Musculoskelet Disord. 2025 Jun 5;26(1):558. doi: 10.1186/s12891-025-08743-4.
We evaluated the biomechanical performance of the new knotless H-Loop technique in repairing the upper third subscapularis (SSC) tendon tear, and compared these results with the single-row knotted technique. A total of 69 subscapularis tendons from sheep were collected, with 10 specimens randomly selected for comprehensive biomechanical testing after either complete tendon or upper third tear. An additional five specimens were dedicated to measuring the size and extent of the footprint area of the SSC tendon. The remaining 44 specimens were randomly and evenly divided into two groups: H-Loop(n = 11) and single-row knotted groups(n = 11). Contact area and pressure, ultimate tensile strength, stiffness, and elongation were assessed. Compared to the single-row knotted technique, the footprint contact pressure repaired by H-Loop technique was significantly larger (mean difference = 5.09 N, p = 0.004), but the footprint contact area (64.09 ± 10.37mm) was similar to that of single-row knotted technique (58.27 ± 9.84mm). The ultimate tensile strength and stiffness of the H-Loop technique were significantly greater than those of the single-row knotted technique (mean difference = 16.58 N, p = 0.003; mean difference = 0.82 N/mm, p = 0.002), while the peak-to-peak elongation was significantly lower (mean difference = 0.51 mm, p = 0.030). The primary failure mode for single-row knotted techniques is suture cut-through at the suture-tendon interface, while for the H-Loop technique, the main failure mode is related to the eyelet. The H-Loop technique provides higher tendon-bone contact pressure and mechanical strength with a smaller gap between the tendon and bone compared to the single-row knotted technique.
我们评估了新型无结H形环技术修复肩胛下肌（SSC）上三分之一肌腱撕裂的生物力学性能，并将这些结果与单排打结技术进行了比较。共收集了69只绵羊的肩胛下肌腱，其中10个标本在肌腱完全撕裂或上三分之一撕裂后随机选择用于全面的生物力学测试。另外5个标本专门用于测量SSC肌腱足迹区域的大小和范围。其余44个标本随机平均分为两组：H形环组（n = 11）和单排打结组（n = 11）。评估了接触面积和压力、极限拉伸强度、刚度和伸长率。与单排打结技术相比，H形环技术修复的足迹接触压力明显更大（平均差异 = 5.09 N，p = 0.004），但足迹接触面积（64.09±10.37mm）与单排打结技术（58.27±9.84mm）相似。H形环技术的极限拉伸强度和刚度明显大于单排打结技术（平均差异 = 16.58 N，p = 0.003；平均差异 = 0.82 N/mm，p = 0.002），而峰峰值伸长率明显更低（平均差异 = 0.51 mm，p = 0.030）。单排打结技术的主要失效模式是缝线在缝线与肌腱界面处被切断，而对于H形环技术，主要失效模式与小孔有关。与单排打结技术相比，H形环技术提供了更高的肌腱-骨接触压力和机械强度，且肌腱与骨之间的间隙更小。
