Novel flat and wide meniscal repair material improves the ultimate load of knot breakage in a porcine trans-capsular meniscal repair model.
Novel flat and wide meniscal repair material improves the ultimate load of knot breakage in a porcine trans-capsular meniscal repair model.
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DOI：
10.1186/s40634-017-0114-4
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发表时间：
2017-12-19
影响因子：
1.8
通讯作者：
Nakata K
中科院分区：
文献类型：
--
作者：
Yokoi H;Mae T;Iuchi R;Take Y;Tachibana Y;Shimomura K;Ohori T;Shino K;Yoshikawa H;Nakata K
在半月板修复过程中，修复部位的高极限负载能力和低循环蠕变是有利的，并且导致手术后撕裂部位良好的生物融合。先前对半月板缝合线的生物力学拉伸测试已确定缝合线结是最薄弱的点。我们假设缝合线结的强度取决于缝合线形状，因此，我们比较了由相同材料和单位长度数量组成的三种不同形状的缝合材料。本研究的目的是确定一种新型扁平宽修复材料（FWRM）（由横截面扁平且宽的编织多线组成）是否可以在使用猪跨囊半月板修复模型的生物力学实验中提高结断裂的极限载荷。使用十八只新鲜冷冻的猪膝（每组n = 6）。内侧半月板中段的纵向撕裂采用经囊由内向外的方法使用以下缝合材料进行修复：2-0号编织聚酯常规缝合线、空心缝合线和FWRM。半月板内段分离并离开后，使用摄像机系统对修复半月板的缝合稳定性进行生物力学分析，以在施加 5 至 20 N 之间的循环载荷 300 次后加宽。还分析了 5 毫米/分钟的极限失效载荷和刚度。我们发现循环负载测试后缝线加宽没有显着差异[传统缝线，平均值 0.51 毫米（S.D. 0.39 毫米）；空心缝线，平均 0.23 毫米（S.D. 0.11 毫米）；和 FWRM，平均值为 0.54 毫米（S.D. 0.08 毫米）]。所有样本的失效模式都是结断裂。与其他组相比，FWRM 在载荷破坏测试中的最终破坏载荷具有统计学意义（传统缝合线，平均 58.8 N [S.D. 8.25 N]；空心缝合线，平均 79.4 N [S.D. 10.2 N]；FWRM，平均 97.4 N [S.D. 3.65 N]； p < 0.05）。 FWRM 在不改变稳定性的情况下提高了结断裂的极限载荷。这种材料可能有助于安全稳定的半月板修复。
In the meniscal repair procedures, a high ultimate load capacity and low cyclic creep at the repair site are favorable and lead to good biological incorporation of the tear site after surgery. Previous biomechanical tensile tests of the meniscal sutures have identified the suture knot as the weakest point. We hypothesized that the strength of a suture knot depends on the suture shape, and therefore, we compared three differently shaped suture materials composed of the same material and quantity per length. The purpose of this study was to determine whether a novel flat and wide repair material (FWRM), which consists of braided multi-threads that are cross-sectionally flat and wide, improves the ultimate load of knot breakage in a biomechanical experiment using a porcine trans-capsular meniscal repair model. Eighteen fresh-frozen porcine knees (n = 6 in each group) were used. A longitudinal tear in the middle segment of the medial meniscus was created and repaired with a trans-capsular inside-out method using the following suture materials: No. 2–0 braided polyester conventional suture, hollow suture, and FWRM. After the separation of the inner segment of the meniscus with leaving, the suture stability of the repaired menisci was biomechanically analyzed with a video camera system for widening after a cyclic load between 5 and 20 N was applied 300 times. Ultimate failure load and stiffness at 5 mm/ min were also analyzed. We found no significant difference in suture widening after cyclic load tests [conventional suture, mean 0.51 mm (S.D. 0.39 mm); hollow suture, mean 0.23 mm (S.D. 0.11 mm); and FWRM, mean 0.54 mm (S.D. 0.08 mm)]. The failure mode in all specimens was knot breakage. Compared with those of the other groups, the ultimate failure load of FWRM was statistically significantly higher in the load-to-failure tests (conventional suture, mean 58.8 N [S.D. 8.25 N]; hollow suture, mean 79.4 N [S.D. 10.2 N]; and FWRM, mean 97.4 N [S.D. 3.65 N]; p < 0.05). FWRM improves the ultimate load of knot breakage without altering stability. This material may contribute to safe and stable meniscus repair.