Suture Anchors

缝合锚钉
  • 文章类型: Journal Article
    UNASSIGNED: To review the development and research progress of suture button fixation Latarjet procedure.
    UNASSIGNED: A comprehensive literature review was conducted to summarize the development and related modified techniques of the suture button fixation Latarjet procedure.
    UNASSIGNED: Since the Latarjet procedure was first introduced by French scholar Latarjet in 1954, it has undergone three key transformations, resulting in suture button fixation Latarjet procedure, which has shown satisfactory outcomes in treatment of recurrent shoulder dislocation. However, there are still drawbacks such as the risk of impingement of the graft on surrounding tissues, and the surgical disruption of anatomical structures like the coracoclavicular ligament and the pectoralis minor muscle. The scholars have proposed several modified techniques based on the suture button fixation Latarjet procedure to further reduce complications from impingement of the graft, to lower the glenohumeral contact pressure, and to eliminate the impact of surgery on the physiological structures of the shoulder joint. The modified techniques include the arthroscopic suture button fixation Latarjet procedure using FiberTape Cerclage, reconstruction of the coracoacromial ligament during congruent-arc Latarjet procedures, and limit unique coracoid osteotomy suture button Latarjet procedure (LU-tarjet procedure). These modified techniques have also shown good clinical outcomes. Additionally, other related modified techniques for reconstruction of the glenoid, such as Chinese unique Inlay Bristow procedure (Cuistow procedure), arthroscopic glenoid bone grafting with soft fixation, and all-arthroscopic modified Eden-Hybinette procedure, have also demonstrated favorable efficacy. However, there is still a lack of long-term follow-up results for these techniques and comparative studies between them.
    UNASSIGNED: Suture button fixation Latarjet procedure is an effective method for the treatment of recurrent shoulder dislocation. There are various techniques, but there is no recognized gold standard, and further clinical and basic research is needed.
    UNASSIGNED: 综述弹性固定Latarjet手术发展历程及研究进展。.
    UNASSIGNED: 查阅国内外弹性固定Latarjet手术相关研究文献,对该术式发展历程及相关改良技术进行总结。.
    UNASSIGNED: 自1954年法国Latarjet教授首次提出Latarjet手术以来,该术式经历了3次关键变革,并逐渐形成了弹性固定Latarjet手术。目前临床应用结果显示弹性固定Latarjet手术治疗复发性肩关节脱位可获得满意疗效,但是仍存在移植骨块与周围组织撞击、手术破坏喙肩弓及胸小肌等解剖结构等不足。为了进一步减少移植骨块撞击带来的并发症、降低盂肱关节接触压力、消除手术对于肩关节原有生理结构的影响,学者们在其基础上提出了使用 FiberTape Cerclage 的关节镜下弹性固定 Latarjet 手术、一致弧Latarjet手术合并重建喙肩韧带、喙突有限截骨线袢固定Latarjet手术(LU-tarjet手术)等相关改良技术,临床应用也获得较好疗效。同时,关节镜下改良嵌入式喙突移位手术(Cuistow手术)、特殊关节盂骨移植技术、关节镜自体髂嵴骨移植术等关节盂重建改良技术也具有良好疗效。但是,目前尚缺乏各项技术的远期随访结果以及各项技术之间的对比研究。.
    UNASSIGNED: 弹性固定Latarjet手术是治疗复发性肩关节脱位的有效术式,有多种改良术式,但尚无公认“金标准”,需要进一步进行临床及基础研究。.
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  • 文章类型: Journal Article
    背景:在肩部手术中经常进行二头肌肌腱长头的肌腱固定术,和全缝合锚钉作为固定方法变得越来越流行。然而,关于全缝线锚钉的最终失效载荷和皮质肱骨插入点的最佳插入角度仍然存在不确定性。
    目的:本研究的目的是比较经常用于肱二头肌肌腱固定术的三种类型的全缝合锚钉的生物力学特性。此外,在猪肱骨模型中观察到两种不同插入角度的影响。
    方法:三种类型的全缝线锚钉的极限失效载荷和失效模式(1.6FiberTak®,1.9FiberTak®,2.6FiberTak®,在12只新鲜冷冻的猪肱骨中以90°和45°的插入角度评估了适用于胸肌下二头肌肌腱固定术的Arthrex®)。锚固件以随机方式在沿着二头肌沟的三个不同插入部位均匀交替插入,并且将缝合线带围绕杆打结以进行拔出测试。总的来说,在通用试验机(Zwick&Roell)中评估了36个锚。
    结果:与1.9FiberTak®(677.8N±57.7N;426.3N±167.0N)相比,2.6FiberTak®在90°插入角(944.0N±169.7N;537.0N±308.8N)下显示出更高的极限失效载荷,p值:0.0080)和1.6FiberTak®(733.0N±67.6N;450.0N±155.8N,p值:0.0018)。所有类型的锚在90°插入角下比在45°插入角下显示出明显更高的极限破坏载荷和更小的标准偏差。主要失效模式是锚杆拔出。只有2.6FiberTak®锚在以90°插入角度放置时显示缝合线断裂作为主要失效模式。
    结论:所有三种全缝合锚钉都是适用于胸肱二头肌下肌腱固定术的固定方法。关于我们的数据,我们建议90°作为最佳插入角度。
    结论:外科医生应了解锚钉尺寸和全缝线锚钉插入角度的影响,以优化最终失效载荷并实现牢固固定。
    BACKGROUND: Tenodesis of the long head of the biceps tendon is frequently performed in shoulder surgery, and all-suture anchors have become more popular as fixation methods. However, uncertainty still exists regarding the ultimate load to failure of all-suture anchors and the best insertion angle at a cortical humeral insertion point.
    OBJECTIVE: The purpose of this study was to compare the biomechanical characteristics of three types of all-suture anchors frequently used for biceps tenodesis. In addition, the influence of two different insertion angles was observed in a porcine humeri model.
    METHODS: The ultimate load to failure and failure mode of three types of all-suture anchors (1.6 FiberTak®, 1.9 FiberTak®, 2.6 FiberTak®, Arthrex®) applicable for subpectoral biceps tenodesis were evaluated at 90° and 45° insertion angles in 12 fresh-frozen porcine humeri. The anchors were inserted equally alternated in a randomized manner at three different insertion sites along the bicipital groove, and the suture tapes were knotted around a rod for pullout testing. In total, 36 anchors were evaluated in a universal testing machine (Zwick & Roell).
    RESULTS: The 2.6 FiberTak® shows higher ultimate loads to failure with a 90° insertion angle (944.0 N ± 169.7 N; 537.0 N ± 308.8 N) compared to the 1.9 FiberTak® (677.8 N ± 57.7 N; 426.3 N ± 167.0 N, p-value: 0.0080) and 1.6 FiberTak® (733.0 N ± 67.6 N; 450.0 N ± 155.8 N, p-value: 0.0018). All anchor types show significantly higher ultimate loads to failure and smaller standard deviations at the 90° insertion angle than at the 45° insertion angle. The major failure mode was anchor pullout. Only the 2.6 FiberTak® anchors showed suture breakage as the major failure mode when placed with a 90° insertion angle.
    CONCLUSIONS: All three all-suture anchors are suitable fixation methods for subpectoral biceps tenodesis. Regarding our data, we recommend 90° as the optimum insertion angle.
    CONCLUSIONS: The influence of anchor size and insertion angle of an all-suture anchor should be known by the surgeon for optimizing ultimate loads to failure and for achieving a secure fixation.
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  • 文章类型: Journal Article
    脊柱融合手术的成功率主要取决于脊柱骨锚的固定强度。这项研究探索了使用L形脊柱骨锚,旨在与椎体的后皮质层建立宏观形状的锁定,从而增加锚的拔出阻力。在腰椎体模(L1-L5)中,通过四个不同的垂直方向(侧向,中间,上级,和劣等)。在拔出实验中,拔出力,并测量锚相对于椎骨的位移,从而确定最大拉出力(平均值:123N±25N)和初始拉出力,锚开始运动所需的初始力(平均值:23N±16N)。值得注意的是,当锚固件接合皮质骨层时,观察到最大拉出力。结果证明了利用具有皮质骨层的宏观形状锁的脊椎骨锚增加拉出力的潜在益处。将宏观形状锁定固定方法与常规椎弓根螺钉相结合显示出显着增强脊柱骨锚固定强度的潜力。
    The success rate of spinal fusion surgery is mainly determined by the fixation strength of the spinal bone anchors. This study explores the use of an L-shaped spinal bone anchor that is intended to establish a macro-shape lock with the posterior cortical layer of the vertebral body, thereby increasing the pull-out resistance of the anchor. The performance of this L-shaped anchor was evaluated in lumbar vertebra phantoms (L1-L5) across four distinct perpendicular orientations (lateral, medial, superior, and inferior). During the pull-out experiments, the pull-out force, and the displacement of the anchor with respect to the vertebra was measured which allowed the determination of the maximal pull-out force (mean: 123 N ± 25 N) and the initial pull-out force, the initial force required to start motion of the anchor (mean: 23 N ± 16 N). Notably, the maximum pull-out force was observed when the anchor engaged the cortical bone layer. The results demonstrate the potential benefits of utilising a spinal bone anchor featuring a macro-shape lock with the cortical bone layer to increase the pull-out force. Combining the macro shape-lock fixation method with the conventional pedicle screw shows the potential to significantly enhance the fixation strength of spinal bone anchors.
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  • 文章类型: Case Reports
    背景:虽然缝合锚钉因其优点而被广泛用于医疗程序中,它们有时会导致并发症,包括锚脱垂。本文介绍了伸肌腱断裂重建手术后小指远端指骨底部缝合锚脱出的独特病例。
    方法:35岁男性,使用不可吸收的缝合锚钉进行伸肌腱断裂重建。七年后,病人去看了我们的门诊病人,抱怨僵硬,疼痛,手术部位突出。最初的X射线成像提示远端指骨骨折或肌腱粘连,但缺乏明确的诊断。随后的磁共振成像(MRI)显示,中部和远端指骨之间的骨连接具有不规则的信号阴影和不清晰的边界,同时保持规则的手指形状。MRI在诊断缝合锚脱出方面被证明是优越的,标志着首例此类病例的报告。手术干预证实了MRI发现。
    结论:缝合锚钉并发症,比如脱垂,是医疗实践中的一个问题。此病例强调了MRI对准确诊断的重要性以及针对这种罕见并发症进行量身定制的手术管理的重要性。
    BACKGROUND: While suture anchors are widely used in medical procedures for their advantages, they can sometimes lead to complications, including anchor prolapse. This article presents a unique case of suture anchor prolapse at the base of the distal phalanx of the little finger after extensor tendon rupture reconstruction surgery.
    METHODS: A 35-year-old male, underwent extensor tendon rupture reconstruction using a non-absorbable suture anchor. After seven years the patient visited our outpatients complaining of stiffness, pain, and protrusion at the surgical site. Initial X-ray imaging suggested suggesting either a fracture of the distal phalanx or tendon adhesion but lacked a definitive diagnosis. Subsequent magnetic resonance imaging (MRI) revealed bone connectivity between the middle and distal phalanges with irregular signal shadow and unclear boundaries while maintaining a regular finger shape. MRI proved superior in diagnosing prolapsed suture anchors, marking the first reported case of its kind. Surgical intervention confirmed MRI findings.
    CONCLUSIONS: Suture anchor complications, such as prolapse, are a concern in medical practice. This case underscores the significance of MRI for accurate diagnosis and the importance of tailored surgical management in addressing this uncommon complication.
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  • 文章类型: Journal Article
    目的:髌骨下极骨折,不像其他髌骨骨折,对传统的手术固定方法提出了挑战。本文介绍了克氏针张力带结合锚钉交叉固定治疗髌骨下极粉碎性骨折的临床技术和效果。
    方法:这项回顾性病例系列研究包括从2020年9月1日至2022年4月30日在我们机构治疗的14例髌骨下极粉碎性骨折患者。所有患者均使用Kirschner钢丝张力带和锚固螺钉交叉缝合技术进行手术。随访评估包括术后X线片以评估骨折愈合,以及临床参数,如愈合时间,视觉模拟量表(VAS)评分,运动范围(ROM),和Bostman得分。
    结果:所有患者平均随访超过12个月,没有内固定失败的病例。膝关节稳定性和功能均优异。X射线显示平均愈合时间约为10.79±1.53周,住院时间为5.64±1.15天,手术时间约为37.86±5.32分钟,术中出血量为33.29±8.15ml。一名患者经历了来自内部固定材料的刺激。在最后的后续行动中,Bostman评分平均28.29±0.83,膝关节屈曲达到131.07°±4.88°,所有患者都实现了膝关节完全伸展,VAS评分为0.36±0.63。
    结论:克氏针张力带与锚钉交叉缝合固定治疗髌骨下极粉碎性骨折的临床疗效满意。这种手术方法,其特点是简单和可靠,是临床实践的宝贵补充。
    OBJECTIVE: Fractures of the inferior patellar pole, unlike other patellar fractures, present challenges for traditional surgical fixation methods. This article introduces the clinical technique and outcomes of using Kirschner wire tension band combined with anchor screw cross-stitch fixation for comminuted inferior patellar pole fractures.
    METHODS: This retrospective case series study included 14 patients with comminuted inferior patellar pole fractures treated at our institution from September 1, 2020, to April 30, 2022. All patients underwent surgery using the Kirschner wire tension band with anchor screw cross-stitch technique. Follow-up assessments involved postoperative X-rays to evaluate fracture healing, as well as clinical parameters such as healing time, Visual Analog Scale (VAS) scores, range of motion (ROM), and Bostman scores.
    RESULTS: All patients were followed for an average of over 12 months, with no cases of internal fixation failure. Knee joint stability and function were excellent. X-rays revealed an average healing time of approximately 10.79 ± 1.53 weeks, hospitalization lasted 5.64 ± 1.15 days, surgery took approximately 37.86 ± 5.32 minutes, and intraoperative blood loss was 33.29 ± 8.15 ml. One patient experienced irritation from the internal fixation material. At the final follow-up, the Bostman score averaged 28.29 ± 0.83, knee joint flexion reached 131.07° ± 4.88°, all patients achieved full knee extension, and the VAS score was 0.36 ± 0.63.
    CONCLUSIONS: Kirschner wire tension band with anchor screw cross-stitch fixation for comminuted inferior patellar pole fractures delivered satisfactory clinical outcomes. This surgical method, characterized by its simplicity and reliability, is a valuable addition to clinical practice.
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  • 文章类型: Case Reports
    我们提出了一个50多岁的健康男人的案例,同时双侧股四头肌腱损伤修复持续6年。股四头肌腱自发性闭合性断裂并不常见。通过患者收集了一例双侧股四头肌腱损伤同时修复的临床资料,笔记和外科医生。诊断主要基于病史和临床检查。在普通射线照相成像上也有暗示特征。尝试使用超声检查进行确认,但产生的报告相互矛盾。筛查患者的任何相关的易感条件,这些易感条件会阻止手术干预或增加复发风险。修复是通过使用缝合锚钉和跨骨环扎加固的组合来完成的。尽管与急性(约90°)相比,被忽略侧的被动屈曲减少(约30°),但肌腱与the骨上极的结合是成功的。随访继续进行术后康复。
    We present a case of a fit man in his 50s, with simultaneous bilateral quadriceps tendon repair of injuries sustained 6 years apart. Spontaneous closed ruptures of the quadriceps tendon are uncommon. Clinical data of a single case of bilateral quadriceps tendon injury with simultaneous repair was gathered via the patient, notes and surgeon. Diagnosis was primarily based on history and clinical examination. Suggestive features on the plain radiographic imaging were also present. Confirmation was attempted using ultrasonography but yielded conflicting reports. The patient was screened for any associated predisposing conditions that would preclude surgical intervention or increase risk of recurrence. Repairs were accomplished by employing a combination of suture anchors and transpatellar cerclage reinforcement. Apposition of the tendon to the superior patellar pole was successful although with decreased passive flexion on the neglected side (approximately 30°) compared with the acute (approximately 90°). Follow-up continues with postoperative rehabilitation.
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  • 文章类型: Case Reports
    背景:尺骨鹰嘴骨折不愈合在单纯骨折中并不常见,由于肘关节解剖结构的破坏,手术治疗具有挑战性。关于手术选择的文献有限,以及确定治疗方法的几个因素,包括骨量的数量和质量,年龄,和关节损伤的程度。
    方法:一名58岁的男性患者出现在临床上,患有被忽视的鹰嘴骨折1年(病例1)。一名74岁的男性(病例2)在鹰嘴骨折手术后表现出持续的疼痛和活动受限。
    方法:两例患者均诊断为鹰嘴骨不连。
    方法:两名患者均接受了非联合片段的切除,并通过三头肌的V-Y前移重新附着。
    结果:手术后活动范围和Mayo肘关节功能评分均得到改善。
    结论:该技术适用于由于骨骼质量和肘关节功能不足而无法接受其他手术选择的患者,它可以导致令人满意的结果,并具有可接受的运动范围和疼痛缓解。
    BACKGROUND: The nonunion of olecranon fractures is uncommon in simple fractures, and it is challenging to treat surgically due to the disruption of the anatomy of the elbow joint. There is limited literature on surgical options, and several factors to determine the treatment, including the amount and quality of bone stock, age, and degree of articular damage.
    METHODS: A 58-year-old man presented at the clinic with neglected olecranon fracture for 1 year (case 1). A 74-year-old man (case 2) presented with consistent pain and limited of motion after surgery for olecranon fracture.
    METHODS: Both patients were diagnosed with olecranon nonunion.
    METHODS: Both patients received the excision of nonunited fragment and reattaching with V-Y advancement of triceps.
    RESULTS: Range of motion and Mayo elbow performance score were improved after surgery.
    CONCLUSIONS: This technique is useful in patients who cannot undergo other surgical options due to insufficient bone quality and elbow function, and it can lead to satisfactory outcomes with an acceptable range of motion and pain relief.
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  • 文章类型: Journal Article
    背景:肩部疾病,特别是肩袖撕裂,是与衰老有关的普遍肌肉骨骼疾病。尽管广泛使用的缝合锚钉技术为肌腱提供了强大的机械支撑,它与术后肌腱再脱的风险有关.常规使用的钛合金会影响磁共振成像的解释。可降解镁合金具有优异的生物相容性,与骨骼相似的机械性能,并刺激Mg2+的骨形成能力。本实验的目的是开发创新的镁基缝合锚钉,通过改进固定材料来增强肩袖修复,并评估其在山羊模型中的可行性。
    方法:我们开发了氟化ZK60缝合锚钉作为两只山羊的植入材料,双肩肩袖修复手术.术后12周进行计算机断层扫描(CT)和组织学分析,并将结果在镁和钛合金组之间进行了比较。此外,进行了血液学检查,其中包括红细胞的评估,白细胞,血小板,凝血功能,肝功能,肾功能,和镁离子浓度。
    结果:术后12周的CT图像显示完整的MgF2ZK60缝合锚钉,有效地将冈下肌腱重新连接到肱骨头。锚在CT扫描中变得不那么明显,指示周围组织的吸收。MgF2组的新骨形成超过Ti组,表现出优越的骨整合。皮质骨和镁之间的相似性降低了应力屏蔽并促进了骨再生。组织学分析显示,MgF2锚成功愈合肌腱,而Ti组显示界面不连续,胶原蛋白分泌减少。血液学检查显示肝脏稳定,肾功能,和镁离子水平。
    结论:研究结果表明,MgF2涂层缝合锚钉可用于肩袖修复和潜在的其他骨科应用。我们希望镁合金锚钉能够成为肩袖肌腱修复手术的解决方案。
    BACKGROUND: Shoulder disorders, particularly rotator cuff tears, are prevalent musculoskeletal conditions related to aging. Although the widely used suture anchor technique provides strong mechanical support to the tendon, it is associated with a risk of postoperative tendon retearing. The conventionally used titanium alloys can affect the interpretation of magnetic resonance imaging. Degradable magnesium alloys possess excellent biocompatibility, similar mechanical property to the bone, and stimulating bone formation ability from Mg2+. The purpose of this experiment was to develop innovative magnesium-based suture anchors to enhance rotator cuff repair by improving fixation materials, and to evaluate their feasibility in a goat model.
    METHODS: We developed fluoridized ZK60 suture anchors as the implantation material for two goats, who underwent rotator cuff repair surgery on both shoulders. Computed tomography (CT) and histological analysis were performed at 12 weeks postoperatively, and the results were compared between the magnesium and titanium alloy groups. Additionally, a hematological examination was conducted, which included assessments of red blood cells, white blood cells, platelets, coagulation function, liver function, kidney function, and magnesium ion concentration.
    RESULTS: The 12-week postoperative CT images showed intact MgF2 ZK60 suture anchors, effectively reconnecting the infraspinatus tendon to the humeral head. The anchors became less visible on CT scans, indicating absorption by surrounding tissues. New bone formation in the MgF2 group surpassed that in the Ti group, demonstrating superior osseointegration. The similarity between cortical bone and magnesium reduced stress-shielding and promoted bone regeneration. Histological analysis revealed successful tendon healing with MgF2 anchors, while the Ti group showed discontinuous interfaces and reduced collagen secretion. Hematological examination showed stable liver, renal function, and magnesium ion levels.
    CONCLUSIONS: The findings indicate that MgF2-coated suture anchors are feasible for rotator cuff repair and potentially other orthopedic applications. We hope that magnesium alloy anchors can become the solution for rotator cuff tendon repair surgery.
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  • 文章类型: Journal Article
    目的:Bankart病变是肱骨关节最常见的病变之一。据报道,Bankart修复的几种双排缝合方法,可以提供更多的稳定性,还有更多的运动限制和并发症。因此,我们引入了一种新的双行Bankart修复技术,关键点双排缝合线,在中线使用一个锚。本文的目的是研究这种新方法的临床效果,并将其与单排缝线进行比较。
    方法:回顾性收集2010年10月至2014年6月行关键点双排缝合或单排缝合的78例患者。基本信息包括性别、年龄,优势臂,并收集了不稳定的发作次数。手术前,通过CT扫描测量关节盂骨丢失。视觉模拟量表,美国肩肘外科医生,加州大学洛杉矶分校的肩秤,在手术前和最后一次随访时评估主观肩价值。
    结果:44例患者(24例接受单排缝合,20例接受关键点双排缝合)均获成功随访。随访期为9.2±1.1年(范围,7.8-11.4年)。在最后一次随访中,所有临床评分均未检测到显著差异.单行组复发率为12.5%,双行组复发率为10%,分别(p=0.795)对单排组14例(31.8%)和双排组9例(26.5%)的患者进行了活动范围测试.仅在90°外展时的内旋差异有统计学意义(单排为48.9°,双排为76.7°,p=0.033)。
    结论:与单行缝合相比,Bankart病变的关键点双行缝合可获得相似的长期结果,一个内侧锚并没有导致有限的运动范围。低复发率和先前的生物力学结果也表明关键点双排缝合是一种可靠的方法。
    OBJECTIVE: Bankart lesion is one of the most common lesions of the glenohumeral joint. Several double-row suture methods were reported for Bankart repair, which could provide more stability, yet more motion limitation and complications. Therefore, we introduced a new double-row Bankart repair technique, key point double-row suture which used one anchor in the medial line. The purpose of this article is to investigate the clinical outcomes of this new method and to compare it with single-row suture.
    METHODS: Seventy-eight patients receiving key point double-row suture or single-row suture from October 2010 to June 2014 were collected retrospectively. The basic information including gender, age, dominant arm, and number of episodes of instability was collected. Before surgery, the glenoid bone loss was measured from the CT scan. The visual analogue scale, American shoulder and elbow surgeons, the University of California at Los Angeles shoulder scale, and subjective shoulder value were valued before surgery and at the last follow-up.
    RESULTS: Forty-four patients (24 patients receiving single-row suture and 20 patients receiving key point double-row suture) were followed up successfully. The follow-up period was 9.2 ± 1.1 years (range, 7.8-11.4 years). At the last follow-up, no significant differences were detected for any of the clinical scores. The recurrence rate was 12.5% for the single-row group and 10% for the double-row group, respectively (p = 0.795) 14 patients (31.8%) in the single-row group and nine patients (26.5%) in the double-row group were tested for active range of motion. A statistically significant difference was found only for the internal rotation at 90° abduction (48.9° for single-row and 76.7° for key point double-row, p = 0.033).
    CONCLUSIONS: The key point double-row sutures for Bankart lesions could achieve similar long-term outcomes compared with single-row suture, and one medial anchor did not result in a limited range of motion. The low recurrence rate and previous biomechanical results also indicate the key point double-row suture is a reliable method.
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  • 文章类型: Journal Article
    目的:开放式缝合(OSu)和微型螺钉锚固(MsA)是两种常用的开放式椎间盘复位手术,用于颞下颌关节(TMJ)的前椎间盘移位(ADD)。这项研究评估了单中心两种外科手术之间的椎间盘位置稳定性(DPS)和髁突骨骼重塑(CBR)的差异。
    方法:使用磁共振成像(MRI)扫描的回顾性队列研究(术前,术后1周和12个月),对2016年1月至2021年6月在一个中心通过两种手术技术(OSu和MsA)进行了开放TMJ椎间盘复位手术的所有患者进行了手术。预测变量是技术(OSu和MsA)。结果变量为DPS和CBR。随访期间,DPS被评为良好,可接受和差,CBR被评为改进,不变,退化。采用多因素分析比较12个月时的DPS和CBR,包括年龄,性别,威尔克斯舞台,术前骨骼状态(正常,轻度/中度异常)和椎间盘重新定位的程度(正常,过度校正,并向后重新定位)。DPS和CBR的相对风险(RR)通过多变量逻辑回归计算。
    结果:385名583个关节的患者被纳入研究。12个月时MRI显示514个关节(93.5%)有良好的DPS,344个关节(62.5%)的CBR有所改善。多变量分析显示,OSu的DPS较高(RR=2.95;95%置信区间[CI],1.27至6.85)和比MsA更好的CBR(RR=1.58;95CI,1.02至2.46)。在影响DPS的因素中,女性比男性有更好的结果(RR=2.63;95CI,1.11~6.26),并且过度矫正或向后重新定位的椎间盘比正常重新定位的椎间盘更稳定(RR=5.84;95CI,2.58~13.20).CBR的改善随着年龄的增加而降低(RR=0.91;95CI,0.89至0.93)。术前轻度/中度异常骨状态与正常术前骨状态相比,CBR改善的可能性更高(RR=2.60;95CI,1.76至3.83)。
    结论:OSu的DPS和CBR优于MsA。性别和椎间盘重新定位的程度影响了DPS,年龄和术前骨骼状态影响CBR。
    OBJECTIVE: Open suturing (OSu) and mini-screw anchor (MsA) are two commonly used open disc repositioning surgeries for anterior disc displacement (ADD) of the temporomandibular joint (TMJ). This study assesses the differences in disc position stability (DPS) and condylar bone remodelling (CBR) between these two surgical procedures in a single centre.
    METHODS: A retrospective cohort study using MRI scans (pre-operation, 1 week and 12 months post-operation) of all patients who had open TMJ disc repositioning surgery from January 2016 to June 2021 at one centre through two surgical techniques (OSu and MsA) was performed. The predictor variable was technique (OSu and MsA). Outcome variables were DPS and CBR. During follow-up, DPS was rated as good, acceptable and poor, and CBR was graded as improved, unchanged, and degenerated. Multivariate analysis was used to compare the DPS and CBR at 12 months after adjusting five factors including age, sex, Wilkes stage, preoperative bone status (normal, mild/moderate abnormal) and the degree of disc repositioning (normal, overcorrected, and posteriorly repositioned). Relative risk (RR) for DPS and CBR was calculated by multivariate logistic regression.
    RESULTS: Three hundred eighty-five patients with 583 joints were included in the study. MRIs at 12 months showed that 514 joints (93.5%) had good DPS, and 344 joints (62.5%) had improved CBR. Multivariate analysis revealed that OSu had higher DPS (RR=2.95; 95% CI, 1.27-6.85) and better CBR (RR=1.58; 95% CI, 1.02-2.46) than MsA. Among the factors affecting DPS, females had better results than males (RR=2.63; 95% CI, 1.11-6.26) and overcorrected or posteriorly repositioned discs were more stable than normally repositioned discs (RR=5.84; 95% CI, 2.58-13.20). The improvement in CBR decreased with age increasing (RR=0.91; 95% CI, 0.89-0.93). Preoperative mild/moderate abnormal bone status had a higher probability of improved CBR compared to normal preoperative bone status (RR=2.60; 95% CI, 1.76-3.83).
    CONCLUSIONS: OSu had better DPS and CBR than MsA. Sex and the degree of disc repositioning impacted DPS, while age and preoperative bone status affected CBR.
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