首页>
外文期刊>Orthopaedic Journal of Sports Medicine
>Suture Anchor Versus Transosseous Tunnel Repair for Inferior Pole Patellar Fractures Treated With Partial Patellectomy and Tendon Advancement: A Biomechanical Study
【24h】
Suture Anchor Versus Transosseous Tunnel Repair for Inferior Pole Patellar Fractures Treated With Partial Patellectomy and Tendon Advancement: A Biomechanical Study
Background: Comminuted inferior pole patellar fractures can be treated in numerous ways. To date, there have been no studies comparing the biomechanical properties of transosseous tunnels versus suture anchor fixation for partial patellectomy and tendon advancement of inferior pole patellar fractures. Hypothesis: Suture anchor repair will result in less gapping at the repair site. We also hypothesize no difference in load to failure between the groups. Study Design: Controlled laboratory study. Methods: Ten cadaveric knee extensor mechanisms (5 matched pairs; patella and patellar tendon) were used to simulate a fracture of the extra-articular distal pole of the patella. The distal simulated fracture fragment was excised, and the patellar tendon was advanced and repaired with either transosseous bone tunnels through the patella or 2 single-loaded suture anchors preloaded with 1 suture per anchor. Load to failure and elongation from cycles 1 to 250 between 20 and 100 N of force were measured, and modes of failure were recorded. Statistical analysis was performed using a paired 2-tailed Student t test. Results: The suture anchor group had less gapping during cyclic loading as compared with the transosseous tunnel group (mean ± SD, 6.83 ± 2.23 vs 13.30 ± 5.74 mm; P = .047). There was no statistical difference in the load to failure between the groups. The most common mode of failure was at the suture-anchor interface in the suture anchor group (4 of 5) and at the knot proximally on the patella in the transosseous tunnel group (4 of 5). Conclusion: Suture anchors yielded similar strength profiles and less tendon gapping with cyclic loading when compared with transosseous tunnels in the treatment of comminuted distal pole of the patellar fractures managed with partial patellectomy and patellar tendon advancement. Clinical Relevance: Suture anchors may offer robust repair and earlier range of motion in the treatment of fractures of the distal pole of the patella. Clinical randomized controlled trials would help clinicians better understand the difference in repair techniques and confirm the translational efficacy in clinical practice.
展开▼
机译：背景：粉碎的较差杆髌骨骨折可以多种方式处理。迄今为止，没有研究过孔隧道的生物力学特性与缝合锚定固定的局部髌骨切除术和肌腱推进劣质髌骨骨折。假设：缝合锚修复将导致修复站点的偏移较少。我们还假设负载不差异，在组之间发生故障。研究设计：受控实验室研究。方法：10个尸体膝盖伸肌机构（5轮匹配对;髌骨和髌骨肌腱）用于模拟髌骨的髁突的骨折骨折。切除远端模拟骨折片段，通过髌骨或2个单装缝合锚固术，用髌骨或2个单装缝合锚固件进行前孔骨隧道修复。测量循环1至250之间的载荷和从循环1至250的力进行测量，并记录失败模式。使用配对的2尾学生T测试进行统计分析。结果：与经骨隧道组相比，缝合线锚组在循环载荷期间具有较少的间隙（平均±SD，6.83±2.23 Vs 13.30±5.74 mm; p = .047）。在组之间的负载中没有统计学差异。最常见的故障模式在缝合线锚组（4/5）中的缝合线 - 锚界面，并且在近侧的髌骨隧道组（4个中的4个）上的结。结论：与髌骨切除术和髌骨切除术和髌骨腱进步的髌骨骨折的粉碎远端杆相比，缝合线锚固率类似于循环载荷的强度曲线和较少的肌腱间隙。临床相关性：缝线锚可以提供鲁棒修复和较早的运动范围，治疗髌骨远端杆的骨折。临床随机对照试验将有助于临床医生更好地了解修复技术的差异，并确认临床实践中的翻译效果。
展开▼
