Superiority of bridging techniques with medial fixation on initial strength
Superiority of bridging techniques with medial fixation on initial strength
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DOI：
10.1007/s00167-012-1922-9
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发表时间：
2012-12-01
影响因子：
3.8
通讯作者：
Eberhardsteiner, Josef
中科院分区：
文献类型：
--
作者：
Anderl, Werner;Heuberer, Philipp R.;Eberhardsteiner, Josef
本研究的目的是利用生物力学动物模型，结合完整肌腱的预测试，评估桥接技术与其他缝合技术在肩袖修复中的初始固定强度。方法采用76头新鲜牛肩进行简单缝合（SS）、褥垫缝合（MS）、梅森-艾伦缝合（MA）、改良双排缝合（mDR）、速桥（SpB）、速桥内固定（mSpB）、双褥垫缝合（dmSuB）等7种缝合方式的试验。在肌腱修复前（预测试）和修复后（主测试），在10和180 N水平下（100 Hz）进行循环加载，位移控制斜坡为+/- 33 mm/s。预试在200次循环后停止。对于主要试验，加载方案最多持续500次循环或直到失效。结果76条完整肌腱的平均伸长率为3.8 +/- 0.6 mm （2.4-5.4 mm）。在第一个周期中，SS、MS、MA和mDR之间的间隙形成没有差异。与所有其他缝合技术相比，SpB显示出明显更高的间隙形成（p = 0.001）。mSpB组与dmSuB组比较差异无统计学意义（p < 0.05），两组比较差异有统计学意义（p < 0.05）。结论：本研究结果表明，与其他缝合技术相比，内侧固定桥接技术具有更好的初始修复强度。了解肩袖修复技术的初始固定强度可能对外科医生有参考价值。
Purpose The purpose of our study was to evaluate the initial fixation strength of bridging techniques compared to other suture techniques for rotator cuff repair using a biomechanical animal model, which incorporated pretesting of intact tendons.Methods Seventy-six fresh bovine shoulders were used for testing seven suture configurations including simple suture (SS), mattress suture (MS), Mason-Allen (MA), modified double row (mDR), SpeedBridge (SpB), SpeedBridge with medial fixation (mSpB), and double-mattress SutureBridge (dmSuB) techniques. Cyclic loading was performed with all intact bone-tendon complex before (pretest) and after repair of the tendon (main test) at the level of 10 and 180 N at 100 Hz with displacement-controlled ramps of +/- 33 mm/s. The pretest was stopped after 200 cycles. For the main test, the loading scheme was continued for a maximum of 500 cycles or until failure.Results The mean elongation of all 76 intact tendons measured at the pretest was 3.8 +/- 0.6 mm (2.4-5.4 mm). No differences of gap formations at the 1st cycle were detected between SS, MS, MA, and mDR. SpB showed significant higher gap formations compared to all other suture techniques (p = 0.001). No significant differences were detected between mSpB and dmSuB, whereas both techniques were significant different when compared to the other groups (p < 0.05).Conclusions In this study, results showed that bridging techniques with medial fixations have superior initial repair strength compared to other suture techniques. Knowledge of initial fixation strength of rotator cuff repair techniques may be of informative value to the surgeon.