Tibiofemoral Contact Mechanics After Horizontal or Ripstop Suture in Inside-Out and Transtibial Repair for Meniscus Radial Tears in a Porcine Model
Tibiofemoral Contact Mechanics After Horizontal or Ripstop Suture in Inside-Out and Transtibial Repair for Meniscus Radial Tears in a Porcine Model
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猪模型半月板径向撕裂由内向外和跨胫骨修复中水平或防撕裂缝合后的胫股接触力学
DOI：
10.1016/j.arthro.2020.10.031
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发表时间：
2021-03-02
影响因子：
4.7
通讯作者：
Zhang, Zheng-Zheng
中科院分区：
文献类型：
--
作者：
Zhang, Hao-Zhi;Zhou, Yun-Feng;Zhang, Zheng-Zheng
目的：比较猪膝关节半月板放射状撕裂的水平缝合、水平缝合和经胫骨缝合修复后的胫股接触力学。方法：对10对配对猪膝关节分别在屈膝0度、30度、60度和90度的1500-N轴向压缩载荷下进行测试。每个膝关节连续接受4种测试条件：(1)完整，(2)内侧半月板放射状撕裂，(3)水平缝合修复，(4)裂开缝合修复。TekScan传感器测量了胫股内侧和外侧间隙的接触压力和接触面积。结果：与分析的各屈曲角度的撕裂状态相比，各修复组的接触力学性能均有改善(均P<0.05)。此外，内向外和经胫骨修复的RipStop缝线在所有屈曲角度下恢复了完整的膝关节接触面积和内侧间隙内的压力(峰值和平均)，而单独水平缝合无法恢复所有屈角下的接触压力60度和90度以及接触面面积。然而，上述参数在内侧向外缝合和经胫骨缝合之间没有显著差异，无论水平或止裂配置(P>；0.05)。结论：在猪半月板模型中，半月板的径向撕裂显著减少了内侧接触面积，增加了平均和最大接触压力。对于放射状撕裂，内向外和经胫骨止裂修补术都有助于恢复所有评估的膝关节屈曲角度下完整的胫股接触力学。
Purpose: To compare tibiofemoral contact mechanics after horizontal or ripstop (horizontal plus vertical) sutures in inside-out and transtibial repair for meniscal radial tears with 10 porcine knees in each group. Methods: Ten matched pairs of porcine knees were tested under a 1500-N axial compressive load at 0 degrees, 30 degrees, 60 degrees, and 90 degrees of knee flexion. Each knee underwent 4 testing conditions consecutively: (1) intact, (2) medial meniscal radial tear, (3) horizontal suture repair configuration, and (4) ripstop suture repair configuration. Tekscan sensors measured tibiofemoral contact pressure and contact area in the medial and lateral compartments. Results: All repair groups improved their contact mechanics when compared with the tear state among all flexion angles analyzed (all P < .05). Furthermore, ripstop sutures with both inside-out and transtibial repairs restored intact knee contact area and pressures (peak and mean) in the medial compartment at all flexion angles, whereas the horizontal sutures alone failed to do so for contact pressures at 60 degrees and 90 degrees and for contact surface areas at all flexion angles. However, the aforementioned parameters were not significantly different between inside-out sutures and transtibial sutures, regardless of horizontal or ripstop configuration (P > .05). Conclusions: Radial tears of the meniscus in a porcine model significantly decreased medial contact area and increased mean and peak contact pressure. Both inside-out and transtibial ripstop repairs for radial tears aid in restoring intact tibiofemoral contact mechanics at all assessed knee flexion angles.