• 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Biomechanical Comparison of Open and Endoscopic Proximal Hamstring Repair Techniques
【24h】

Biomechanical Comparison of Open and Endoscopic Proximal Hamstring Repair Techniques

机译：开放式和内镜式近端腿筋修复技术的生物力学比较

获取原文
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Objectives: Proximal hamstring tendon avulsions are a rare subset of hamstring injuries, and surgical fixation has become standard, given superior outcomes compared to nonoperative treatment. Open surgical techniques employ a large incision near the gluteal crease and necessitate extensive retraction for optimal visualization, which may increase risk for infection, numbness and potential sciatic nerve injury. Recently described endoscopic repair techniques enable optimal visualization and access to the tendon and ischial tuberosity through several small incisions, potentially reducing risks associated with open repair. Prior cadaveric studies have evaluated biomechanical properties of open repair techniques. The purpose of this study was to compare the biomechanical properties of open and endoscopic suture anchor repair of proximal hamstring ruptures to validate the structural integrity of the endoscopic technique. Methods: Nine fresh-frozen cadaver pelvises (5 M, 4F) were randomly assigned open proximal hamstring repair, with subsequent contralateral endoscopic proximal hamstring repair. Laterality was evenly distributed. Open repair was performed after reflection of the gluteus maximus to optimize visualization and anchor placement during repair, while endoscopic repair was performed via four small incisions surrounding the ischial tuberosity. Proximal hamstring ruptures were simulated by subperiosteal dissection of the entire tendon from its insertion. Repairs were performed using two double-loaded 3.0 mm polyether ether ketone (PEEK) suture anchors and two 3.75 mm PEEK knotless screw-in anchors in a double-row configuration. After repair, the ischial tuberosity was harvested by cutting the inferior pubic ramus and superior aspect of the ischial tuberosity as far away from the repair site as possible. The bony inferior ramus and ischial tuberosity was potted into an acrylic cylinder using polymethylmethacrylate, while the musculotendinous junction was wrapped in gauze and clamped 3 cm from the insertion. Reference lines were marked at the insertion site and 1, 2, and 3 cm from the insertion to aid optical measurements. Potted specimens were mounted into an MTS 858 MiniBionix servohydraulic test frame and tested according to a previously established protocol. Each specimen was cycled 50 times within a pre-established range, with the range increased every 50 cycles until failure. Values were then compared using a paired t-test. Results: The open repair group failed at a mean of 119 cycles with an average displacement of 12.7 mm at a mean ultimate load of 574.5 N. The endoscopic repair group failed at a mean of 117 cycles with an average displacement of 14.9 mm at and mean ultimate load of 563.4 N. No statistically significant difference was noted among any of these parameters. Conclusion: This biomechanical analysis demonstrated no difference in the structural properties comparing open and endoscopic techniques. Endoscopic proximal hamstring repair is a viable option for surgical fixation of proximal hamstring avulsions, with the potential to decrease risks encountered using open techniques.
机译：目的：近端绳肌腱撕脱是of绳肌损伤的罕见子集，并且与非手术治疗相比，手术固定已成为标准方法，具有更好的效果。开放式手术技术在臀折痕附近采用大切口，必须进行广泛的牵开才能获得最佳的可视化效果，这可能会增加感染，麻木和潜在坐骨神经损伤的风险。最近描述的内窥镜修复技术能够通过几个小切口实现最佳的可视化，并能接近肌腱和坐骨结节，从而有可能降低与开放式修复相关的风险。先前的尸体研究已经评估了开放修复技术的生物力学特性。这项研究的目的是比较近端绳断裂的开放和内镜缝合锚钉修复的生物力学特性，以验证内镜技术的结构完整性。方法：将9只新鲜冷冻的尸体骨盆（5 M，4F）随机分配为开放性近端腿筋修复，随后进行对侧内镜下近端腿筋修复。横向分布均匀。臀大肌反射后进行开放性修复，以优化修复过程中的可视化和锚定位置，而内窥镜修复则通过围绕坐骨结节的四个小切口进行。通过将整个肌腱从其插入处进行骨膜下解剖来模拟近端腿筋断裂。使用两个双排3.0 mm聚醚醚酮（PEEK）缝合锚钉和两个3.75 mm PEEK无结螺旋拧入锚钉进行修复。修复后，通过切割下耻骨下支和坐骨结节的上端尽可能远离修复部位，收获坐骨结节。用聚甲基丙烯酸甲酯将下颌骨下支和坐骨结节装进丙烯酸圆柱体中，同时用网纱包裹肌腱末端，并从插入处夹紧3 cm。在插入部位和距插入部位1、2和3厘米处标记参考线，以帮助进行光学测量。将盆栽标本安装到MTS 858 MiniBionix伺服液压测试架中，并根据先前建立的协议进行测试。每个标本在预定范围内循环50次，该范围每50个循环增加一次，直到失效。然后使用配对t检验比较值。结果：开放式修复组平均失败119个周期，平均位移为12.7 mm，平均极限载荷为574.5N。内窥镜修复组平均失败117个周期，平均位移为14.9 mm。最终载荷为563.4N。在这些参数中，没有发现统计学上的显着差异。结论：该生物力学分析表明，与开放式和内窥镜技术相比，其结构特性没有差异。内窥镜近端腿筋修补术是近端腿筋撕脱伤外科手术固定的可行选择，有可能降低使用开放式技术遇到的风险。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号