Meta-analysis on biomechanical properties of meniscus repairs: are devices better than sutures?
Meta-analysis on biomechanical properties of meniscus repairs: are devices better than sutures?
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DOI：
10.1007/s00167-014-2966-9
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发表时间：
2015-01-01
影响因子：
3.8
通讯作者：
Rosso, Claudio
中科院分区：
文献类型：
--
作者：
Buckland, Daniel M.;Sadoghi, Patrick;Rosso, Claudio
据文献报道，在过去的几十年里，半月板修复装置已经进行了广泛的测试。对不同的半月板修复装置和缝合线的生物力学特性进行综述。为了进行这项荟萃分析，我们在PubMed、EMBASE、CCTR和CINAHL上进行了系统的在线搜索，检索词为半月板或半月板和生物力学和修复)。载荷失效(LTF)、僵硬和循环结果的测量是独立提取的，一式两份。系统的搜索共发现了841份手稿。排除重复和不相关的出版物后，仍有41项研究有待最后分析。这些研究从1995年到2013年以英语和德语发表。总体而言，与器械相比，缝合线具有更高的LTF[缝合：87.7+/-A 0.3N(加权平均+/-A标准误差)，装置：56.3+/-A 0.1N]和硬度(缝合：8.9+/-A 0.04N/mm，装置：8.6+/-A 0.04N/mm)。在LFT测试中，PDS0垂直(145.0+/-A8.1N)、OrthoCord2-0(143.6+/-A11.3N)和Ethiond No 0垂直(133.4+/-A7.7N)是最牢固的缝合，半月板Viper(140.9+/-A5.1N)、MaxFire垂直(136.2+/-A11.3N)和Fast-Fix垂直(115.2+/-A1.6N)是最牢固的装置。第二代设备明显比第一代设备更坚固(p<；0.001)。缝合修复仍然是黄金标准，垂直方向的缝合结构比水平方向的缝合结构显示出更好的LTF值。然而，一些半月板修复装置具有与缝合修复类似的生物力学特性。缝合修复和装置在半月板修复中都占有一席之地。没有一个是对照实验室研究的荟萃分析。
Meniscal repair devices have been extensively tested during the past decades as reported in the literature. Reviewing the different meniscal repair devices and sutures with their respective biomechanical properties.For this meta-analysis, we conducted a systematic online search using PubMed, EMBASE, CCTR, and CINAHL using the search terms Meniscus OR Meniscal AND Biomechanics AND Repair). Load-to-failure (LtF), stiffness, and cyclic outcome measures were extracted independently and in duplicate. The systematic search revealed 841 manuscripts in total. After exclusion of duplicates and irrelevant publications, 41 studies remained for final analysis. The studies were published in English and German from 1995 to 2013. Due to differing cyclic force protocols, cyclic outcomes had to be excluded.Overall, sutures had a higher LtF [suture: 87.7 +/- A 0.3 N (weighted mean +/- A standard error), device: 56.3 +/- A 0.1 N] and stiffness (suture: 8.9 +/- A 0.04 N/mm, device: 8.6 +/- A 0.04 N/mm) than devices, both p < 0.05. In LfT testing, PDS 0 Vertical (145.0 +/- A 8.1 N), OrthoCord 2-0 (143.6 +/- A 11.3 N), and Ethibond No 0 Vertical (133.4 +/- A 7.7 N) were the strongest sutures and Meniscal Viper (140.9 +/- A 5.1 N), MaxFire Vertical (136.2 +/- A 11.3 N), and FasT-Fix Vertical (115.2 +/- A 1.6 N) were the strongest devices. Second-generation devices were significantly stronger and stiffer than first-generation devices (p < 0.001).Suture repair remains the gold standard with a vertically oriented suture configuration showing superior LtF values compared to a horizontal configuration. Nevertheless, some meniscal repair devices have similar biomechanical properties to suture repairs. Both suture repairs and devices have a place in meniscal restoration.None, meta-analysis of controlled laboratory studies.