Barber F A, Herbert M A, Click J N
Orthopedic and Sports Medicine Center, Plano, Texas 75075, USA.
Arthroscopy. 1996 Feb;12(1):32-38. doi: 10.1016/s0749-8063(96)90216-9.
The rapid proliferation of suture anchors continues. Our prior report on the pullout strength of 14 different anchors is supplemented by a similar test conducted on 8 additional anchors. Comparative data on modes of failure and failure strengths (ultimate loads to failure) for these new devices are compared statistically with the previously tested anchors. In a fresh never-frozen porcine femur model, 10 samples of each of the additional anchors tested were threaded with stainless steel sutures and inserted into three different test areas (diaphyseal cortex, metaphyseal cortex, and a cancellous trough). Tensile stress parallel to the axis of insertion was applied at a rate of 12.5 mm/s by an Instron 1321 testing machine (Instron Corp, Canton, MA) until failure and mean anchor failure strengths calculated. The anchors tested were the Mitek G2 as a control, miniMitek, Mitek Superanchor, Mitek Rotator Cuff anchor (Mitek Products, Westwood, MA), Innovasive Devices Radial Osteal Compression device (Innovasive Devices, Hopkinton, MA), Arthrex Fastak (Arthrex Inc, Naples, FL), Arthrotek miniHarpoon (Arthrotek, Warsaw, IN), Orthopedic Biosystems PeBA 3 and PeBA 5 (Orthopedic Biosystems, Scottsdale, AZ), and AME 5.5 screw (American Medical Electronics, Richardson, TX). Failure mode (anchor pullout, suture eyelet cut out, or wire breakage) was generally consistent for each anchor type. The size of insertion hole is clinically important and each anchor's performance was evaluated as a function of its minor diameter or drill hole. For screw anchors, the larger the minor diameter of the screw, the higher the mean failure strengths in all three test areas (P = .001). However, larger drill holes for non-screw anchors resulted in lower mean failure strengths in cancellous bone (P = .03) and diaphyseal cortex (P < .005).
缝线锚钉的迅速普及仍在继续。我们之前关于14种不同锚钉拔出强度的报告，因对另外8种锚钉进行了类似测试而得到补充。这些新器械的失效模式和失效强度（失效时的极限载荷）的对比数据，与之前测试的锚钉进行了统计学比较。在一个全新的从未冷冻过的猪股骨模型中，对每种额外测试的锚钉取10个样本，用不锈钢缝线穿入，插入三个不同的测试区域（骨干皮质、干骺端皮质和松质骨槽）。通过英斯特朗1321测试机（英斯特朗公司，马萨诸塞州坎顿）以12.5毫米/秒的速率施加平行于插入轴的拉伸应力，直至失效，并计算出平均锚钉失效强度。所测试的锚钉包括作为对照的Mitek G2、迷你Mitek、Mitek超级锚钉、Mitek肩袖锚钉（Mitek产品公司，马萨诸塞州韦斯特伍德）、Innovasive Devices桡骨骨压缩装置（Innovasive Devices公司，马萨诸塞州霍普金顿）、Arthrex Fastak（Arthrex公司，佛罗里达州那不勒斯）、Arthrotek迷你鱼叉（Arthrotek公司，印第安纳州华沙）、骨科生物系统公司的PeBA 3和PeBA 5（骨科生物系统公司，亚利桑那州斯科茨代尔）以及AME 5.5螺钉（美国医疗电子公司，得克萨斯州理查森）。每种锚钉类型的失效模式（锚钉拔出、缝线孔眼切断或钢丝断裂）通常是一致的。插入孔的大小在临床上很重要，每种锚钉的性能根据其小径或钻孔进行评估。对于螺钉锚钉，螺钉的小径越大，在所有三个测试区域的平均失效强度就越高（P = 0.001）。然而，对于非螺钉锚钉，较大的钻孔在松质骨（P = 0.03）和骨干皮质（P < 0.005）中导致较低的平均失效强度。
