Biomechanical Comparison of Four- versus Six-Strand Transosseous Suture Repair for Patellar Tendon Rupture.
Biomechanical Comparison of Four- versus Six-Strand Transosseous Suture Repair for Patellar Tendon Rupture.
复制标题
四股与六股经骨缝合线修复髌腱断裂的生物力学比较。
DOI：
10.1055/s-0043-1766094
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发表时间：
2024
期刊：
影响因子：
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通讯作者：
Jauregui,JulioJ
中科院分区：
文献类型：
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作者：
Zhang,Tina;Wahl,Alexander;Schneider,Matheus;Xu,Dali;Hahn,Alexander;Meredith,SeanJ;Packer,JonathanD;Leong,NatalieL;Zhang,Li-Qun;Henn3rd,RFrank;Jauregui,JulioJ
背景：髌骨肌腱断裂导致膝关节伸肌机制功能丧失，需要手术修复。然而，在比较经骨缝合与缝合锚钉修复技术时，生物力学研究报告了相互矛盾的结果。这种差异可能是由于实验设计的不一致，因为这些研究使用了不同数量的缝合线。因此，本研究的主要目的是比较四股和六股经骨缝合修复的最终负荷。次要目标是比较循环加载后的间隙形成和破坏模式。方法将6对新鲜冷冻尸体标本随机分为四股或六股经骨缝合修复。试样经过预处理循环加载，然后加载至失效。结果与四链修复相比，六链修复的最大失效负荷显著增加（平均差值为319.3 N [57.9%],p= 0.03）。循环加载和最大加载后，间隙长度无显著差异。两组在失败方式上无显著差异。结论：与四股结构相比，采用六支架经髌骨肌腱修复结构加一根额外缝线可使整体结构强度提高50%以上。
BackgroundSurgical repair is indicated for patellar tendon ruptures that result in loss of knee extensor mechanism function. However, biomechanical studies report conflicting results when comparing transosseous suture versus suture anchor repair techniques. This discrepancy may be due to inconsistencies in experimental design as these studies use various numbers of suture strands. Therefore, the main objective of this study is to compare the ultimate load of four- versus six-strand transosseous suture repair. Secondary objectives are to compare gap formation after cyclical loading and mode of failure.MethodsSix pairs of fresh-frozen cadaveric specimen were randomly allocated to either four- or six-strand transosseous suture repair. Specimen underwent preconditioning cyclical loading and then load to failure.ResultsThe six-strand repair had a significantly higher maximum load to failure compared with the four-strand repair (mean difference = 319.3 N [57.9%],p= 0.03). There was no significant difference in gap length after cyclical loading or at max load. There were no significant differences in mode of failure.ConclusionUtilizing a six-stand transosseous patella tendon repair construct with one additional suture increases overall construct strength by over 50% compared with a four-strand construct.