Repair of patellar tendon rupture with suture anchors
Repair of patellar tendon rupture with suture anchors
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DOI：
10.1016/j.arthro.2006.10.023
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发表时间：
2007-08-01
影响因子：
4.7
通讯作者：
Re, Louis
中科院分区：
文献类型：
--
作者：
Capiola, David;Re, Louis
髌腱断裂的修复通常使用穿过髌骨内骨内隧道的缝线进行。然而，这种方法有一些需要注意的问题。Beath针可能会穿透关节面，或者可能会通过多次穿过过度损伤股四头肌。已经受伤的髌腱在清创和插入骨隧道后可能会过度缩短，并可能发生隧道松动。倾斜的骨隧道可能导致髌骨异常倾斜，导致力分布不均匀。本技术说明报告了使用3个缝线锚钉进行替代修复的详细信息，该锚钉与6股Krackow技术结合，并根据需要使用额外的褥式缝合。由于锚钉的低切迹特性，该技术可以更准确地在髌骨下极重建足印，避免关节软骨穿透和周围软组织损伤。消除了通过骨隧道松动或产生异常应力的可能性。使用较小的切口，手术（止血带）时间缩短。尽管锚钉的拔出可能是一个合乎逻辑的问题，但之前的研究表明，这种结构足以承受其所承受的力。
Repair of a ruptured patellar tendon is usually performed with the use of sutures that are passed through intraosseous tunnels within the patella. However, a number of caveats pertain to this method. The Beath pin may penetrate the articular surface or may unduly injure the quadriceps through multiple passes. The already injured patellar tendon may be overly shortened after debridement and insertion into bony tunnels, and loosening through the tunnels may occur. Obliquely oriented bony tunnels may cause abnormal patellar tilt, leading to uneven force distribution. This technical note reports the details of an alternative repair with 3 suture anchors that is incorporated into a 6-stranded Krackow technique, with additional mattress sutures as needed. Because of the low-profile nature of the anchors, this technique more accurately re-creates the footprint at the inferior pole of the patella and avoids articular cartilage penetration and injury to the surrounding soft tissue. The possibility of loosening through bony tunnels or creation of abnormal stresses is eliminated. A smaller incision is used, and operative (tourniquet) time is diminished. Although pullout of the anchors may be a logical concern, previous studies have suggested that this construct is more than sufficient to withstand the forces to which it is subjected.