后内侧半月板根部撕裂中无结缝线锚钉固定与经骨隧道缝线纽扣固定的生物力学比较
简介
该尸体生物力学研究比较了无结全缝线锚钉与传统经胫骨缝线纽扣固定修复后内侧半月板根部撕裂的效果。在0°、30°和60°屈膝时两组接触面积与压力无显著差异，但90°屈膝时锚钉组的接触面积和压力均优于对照组。无结全缝线锚钉修复技术力学性能不劣于甚至优于传统方法，且无需钻透胫骨，操作更简单，可作为可行的替代方案。
英文摘要
BACKGROUND: Posterior medial meniscal root (PMMR) tears have been shown to create a biomechanically unfavorable environment for knee cartilage. While various PMMR repair methods have been shown to restore normal knee biomechanics, there is little consensus on the ideal repair technique. PURPOSE: To compare PMMR repair using a knotless all-suture anchor versus traditional transosseous fixation using a suture button. STUDY DESIGN: Controlled laboratory study. METHODS: Ten matched pairs of fresh-frozen cadaveric knees were biomechanically tested in intact, torn, and surgically repaired conditions. One limb from each donor was repaired using a traditional suture and bone tunnel technique (control group), while the contralateral limb was repaired with a knotless all-suture anchor (anchor group). The limbs were distributed equally between the 2 surgical procedure groups, so that each group contained a nearly equal number of right and left knees. RESULTS: There were no significant differences in normalized contact area or normalized contact pressure between control and anchor groups at 0°, 30°, or 60° of knee flexion. Contact pressure returned to near-intact values at 0°, 30°, and 60° for both groups. This was also the case at 90° for the anchor group. However, the control group did not return to intact values at 90°, resulting in a significantly (P = .007) higher normalized contact pressure in the control group compared with the anchor group. This finding was also true at 90° for normalized contact area, which was significantly lower (P = .0001) in the control group than in the anchor group. CONCLUSION: At time zero, knotless all-suture repair of PMMR tears performed biomechanically similarly or better than transosseous suture button fixation at 0°, 30°, and 60° of flexion, with significantly improved contact area and contact pressure at 90° of flexion. Thus, knotless all-suture anchor repair may represent a viable alternative technique for PMMR repair. CLINICAL RELEVANCE: The knowledge that knotless all-suture anchor repair performed as well as or better than a more traditional technique allows for a technically simpler surgery, which precludes the need for drilling through the tibia.