A biomechanical study of four different meniscal repair systems, comparing pull-out strengths and gapping under cyclic loading
A biomechanical study of four different meniscal repair systems, comparing pull-out strengths and gapping under cyclic loading
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DOI：
10.1007/s00167-002-0324-9
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发表时间：
2003-01-01
影响因子：
3.8
通讯作者：
Amis, AA
中科院分区：
文献类型：
--
作者：
McDermott, ID;Richards, SW;Amis, AA
大多数研究比较了不同假体修复系统的生物力学特性，只是简单地研究了失效载荷。半月板组织是高度各向异性的，并且在径向方向上的张力下弱得多。因此，径向方向的失效载荷可能不是修复周向撕裂的最具生理相关性的体外试验，在较低载荷的循环载荷下确定修复部位的间隙可能更重要。使用牛心包，使用简单的垂直2-0 PDS缝线、半月板箭头、半月板紧固件或T-Fix修复垂直环形切口。通过在材料试验机中简单加载至失效，以及通过在5和10 N之间的循环加载25个循环来测试修复。使用数字测微计测量修复后的初始间隙，使用差分电压磁阻传感器测量循环载荷下间隙的增加。每个修复组的平均失效载荷为：缝线72.7 N、Arrows 34.2 N、紧固件40.8 N和T-Fix 49.1 N。缝线的失效载荷显著大于Arrows或紧固件。25次加载循环后，每个修复组的平均间隙为：缝线3.29 mm，Arrows 2.18 mm，紧固件3.99 mm和T-Fix 3.47 mm。Arrows的平均间隙显著小于缝线、紧固件或T-Fix。这些结果证实，通过缝合进行半月板修复可提供最高的失效载荷，但也表明，在测试的四种方法中，箭头在较低载荷下提供了更好的上级固定，并且在循环载荷下修复间隙最小。
Most studies comparing the biomechanical properties of different meniscal repair systems have simply investigated load to failure. Meniscal tissue is highly anisotropic, and far weaker under tension in the radial direction. Radially oriented loading to failure may not therefore be the most physiologically relevant in vitro test for repair of circumferential tears, and determining gapping across repair sites under cyclical loading at lower loads may be of greater importance. Using bovine menisci, vertical circumferential incisions were repaired using a simple vertical 2-0 PDS suture, Meniscal Arrow, Meniscal Fastener or T-Fix. Repairs were tested by simple loading to failure in a materials testing machine, and by cyclic loading between 5 and 10 N for 25 cycles. Initial gapping across the repairs was measured using a digital micrometer, and the increase in gapping under cyclic loading measured using a Differential Voltage Reluctance Transducer. The mean loads to failure for each of the repair groups were: sutures 72.7 N, Arrows 34.2 N, Fasteners 40.8 N and T-Fix 49.1 N. The load to failure was significantly greater with sutures than with Arrows or Fasteners. The mean gapping across the repairs for each of the repair groups after 25 loading cycles were: sutures 3.29 mm, Arrows 2.18 mm, Fasteners 3.99 mm and T-Fix 3.47 mm. The mean gapping was significantly less with Arrows than with Sutures, Fasteners or T-Fix. These results confirm that meniscal repair by suturing gives the highest load to failure, but show that Arrows give superior hold under lower loads, with the least gapping across repairs under cyclic loading of the four methods tested.