Part II: Biomechanical assessment for a footprint-restoring transosseous-equivalent rotator cuff repair technique compared with a double-row repair technique
Part II: Biomechanical assessment for a footprint-restoring transosseous-equivalent rotator cuff repair technique compared with a double-row repair technique
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DOI：
10.1016/j.jse.2006.09.011
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发表时间：
2007-07-01
影响因子：
3
通讯作者：
Lee, Thay Q.
中科院分区：
文献类型：
--
作者：
Park, Maxwell C.;Tibone, James E.;Lee, Thay Q.
我们假设，与双排技术相比，经骨等效修复将证明肌腱和结节之间的抗张强度和间隙形成得到改善。在6个新鲜冷冻的人肩关节中，进行了经骨等效肩袖修复：将两个内侧锚钉的缝线分支桥接在肌腱上，并使用界面螺钉进行外侧固定。在6个对侧配对标本中，进行了双排修复。对于所有修复，使用材料试验机对每个修复施加10 N至180 N的循环载荷，持续30个循环;对每个修复进行拉伸试验，以1 mm/sec的变形速率测量失效载荷。肌腱边缘和止点之间的间隙形成用视频数字化系统测量。与双排技术（299.2 +/- 52.5 N）相比，经骨等同技术（443.0 +/- 87.8 N）的平均极限失效载荷显著更大（P = 0.043）。经骨等效技术和双排技术在循环载荷期间的间隙形成没有显著差异，平均值分别为3.74 +/- 1.51 mm和3.79 +/- 0.68 mm（P = 0.95）。两种结构的油循环刚度无统计学差异（P > 0.40）。与双排技术相比，经骨等效肩袖修复技术提高了极限失效载荷。两种技术的间隙形成相似。经骨等效修复有助于恢复足印尺寸，并提供比双排技术更强的修复，这可能有助于优化愈合生物学。
We hypothesized that a transosseous-equivalent repair would demonstrate improved tensile strength and gap formation between the tendon and tuberosity when compared with a double-row technique. In 6 fresh-frozen human shoulders, a transosseous-equivalent rotator cuff repair was performed: a suture limb from each of two medial anchors was bridged over the tendon and fixed laterally with an interference screw. In 6 contralateral matched-pair specimens, a double-row repair was performed. For all repairs, a materials testing machine was used to load each repair cyclically from 10 N to 180 N for 30 cycles; each repair underwent tensile testing to measure failure loads at a deformation rate of I mm/sec. Gap formation between the tendon edge and insertion was measured with a video digitizing system. The mean ultimate load to failure was significantly greater for the transosseous-equivalent technique (443.0 +/- 87.8 N) compared with the double-row technique (299.2 +/- 52.5 N) (P = .043). Gap formation during cyclic loading was not significantly different between the transosseous-equivalent and double-row techniques, with mean values of 3.74 +/- 1.51 mm and 3.79 +/- 0.68 mm, respectively (P = .95). Stiffness for oil cycles was not statistically different between the two constructs (P > .40). The transosseous-equivalent rotator cuff repair technique improves ultimate failure loads when compared with a double-row technique. Gap formation is similar for both techniques. A transosseous-equivalent repair helps restore footprint dimensions and provides a stronger repair than the double-row technique, which may help optimize healing biology.