Biomechanical Analysis of Scapholunate Ligament Repair Techniques
| Autor: | Michelle G. Carlson, Eugene T. Ek, Kathleen N. Meyers, Krystle A. Hearns, Lana Kang, Mike T. Wei |
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| Rok vydání: | 2015 |
| Předmět: |
Scaphoid Bone
Fibrous joint medicine.medical_specialty Carpal Joints business.industry Suture Techniques Scapholunate joint Wrist Scapholunate ligament Surgery medicine.anatomical_structure Cadaver Suture Anchors Tensile Strength Ligaments Articular Load to failure Ligament medicine Humans Orthopedics and Sports Medicine Lunate Bone business Cadaveric spasm |
| Zdroj: | The Journal of Hand Surgery. 40:1534-1539 |
| ISSN: | 0363-5023 |
| DOI: | 10.1016/j.jhsa.2015.03.031 |
| Popis: | Purpose To evaluate the biomechanical properties of 3 scapholunate repair techniques. Methods In 51 cadavers, the scapholunate ligament was exposed through a dorsal approach, incised at its scaphoid insertion, and repaired using 1 of 3 techniques: 2 single-loaded suture anchors, 2 double-loaded suture anchors, or 2 transosseous sutures. Twenty-four repaired specimens underwent load to failure (LTF) testing using tensile distraction on a servo-hydraulic machine. Twenty-seven specimens underwent cyclical testing to measure gap formation at the scapholunate joint. Results The mode of failure was suture pullout through the substance of the ligament in 22 specimens, failure at the bone suture interface in 1, and anchor pullout in 1. Double-loaded anchor repairs demonstrated a significantly higher mean ultimate LTF compared with single-loaded anchor (91 N vs 35 N) and transosseous (91 N vs 60 N) repairs. Transosseous repairs demonstrated a higher mean ultimate LTF compared with single-loaded suture repairs (60 N vs 35 N). After 300 cycles, the average gap for the transosseous repair group was double that for the single- and double-loaded repairs, although not statistically significant. Conclusions Primary scapholunate ligament repairs using double-loaded suture anchors demonstrated significantly higher strength compared with single-loaded anchors and transosseous repairs. On cyclic loading, transosseous repairs demonstrated the greatest gap formation with no measurable difference between single- and double-loaded repairs. Clinical relevance In a cadaveric model for primary repairs, double-loaded suture anchors demonstrated the highest LTF and offer a similar but unproven performance in vivo . |
| Databáze: | OpenAIRE |
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