新型跟腱缝合与常规跟腱缝合的生物力学特性对比研究

Biomechanical characteristics of suture configurations of channel assisted minimally invasive repair versus routine methods in Achilles tendon rupture

目的比较新型跟腱微创缝合系统与两种常用跟腱微创缝合方式的生物力学特性。方法随机将18根猪跟腱样本分为3组(每组6根),分别模拟新型跟腱微创缝合CAMIR式、常规微创Ma-Griffith式和常规微创Achillon式进行缝合,对各样本均进行预加载50 N,2 min,然后分别以20~100 N、20~191 N、20~369 N三个阶段循环加载,每个阶段1 000次,加载频率1 Hz。缝合失效定义为缝线断裂或缝线切割并豁出跟腱。结果循环1 000次时,CAMIR组的伸长量长于Achillon组,差异有统计学意义(P<0.05)。CAMIR组、Ma-Griffith组均在20~100 N循环结束时缝合失效,Achillon组则在20~191 N结束后缝合失效。循环10次时3组伸长量差异无统计学意义(P=0.834)。结论新型CAMIR跟腱微创缝合系统缝合强度可靠,可降低线结反应风险,是一种值得推荐的跟腱微创缝合技术。

Objective To study the biomechanical characteristics of suture configurations using channel assisted minimally invasive repair （CAMIR） versus two regular methods in Achilles tendon rupture. Methods A total of 18 porcine Achilles tendon samples were randomly divided into 3 groups （6 per group）, and underwent CAMIR, Ma-Griffith （as control） and Achillon （as control） respectively. Each sample was preloaded with 50 N for 2 min, and then were cycled 1 000 times at 1 Hz between magnitudes of 20 to 100 N, 20 to 191 N, and 20 to 369 until failure. Failure was defined as suture breakage, or suture pullout. Results There was no significant difference in elongation between all groups after 10 cycles. After the first 1 000 cycles, CAMIR group had a elongations of 7.32 ± 1.67 mm and Ma-Griffith group had a elongation of 7.62 ± 1.81 mm with no significant difference （P=0.078）, but both of them were longer than that of Achillon group （3.19 ± 0.61 mm） （P=0.000, respectively）. Meanwhile, the number of cycles to failure in CAMIR group was 1 000（1 000, 1 000）, equivalent to 1 000 （1 000, 1 000） in Ma-Griffith group, while significantly lower than 2 000 （2 000, 2 007） in Achillon group （P 〈 0.05）. Conclusion The strength of CAMIR suture is reliable. In addition, with lower number of suture strands and knots, the CAMIR suture can reduce the risk of suture reactivity. The CAMIR system is worth to be recommended for Achilles tendon rapture.