Optimal suturing techniques in patch-bridging reconstruction for massive rotator cuff tears: A finite element analysis

Yuting Zhong , Chengxuan Yu , Sijia Feng , Han Gao , Luyi Sun , Yunxia Li , Shiyi Chen , Jun Chen
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Abstract

Purpose

To use a finite element method to construct a patch-bridge repair model for massive rotator cuff tears (MRCTs) and investigate the effects of different suture methods and knot numbers on postoperative biomechanics.

Methods

A finite element model based on intact glenohumeral joint data was used for a biomechanical study. A full-thickness defect and retraction model of the supraspinatus tendon simulated MRCTs. Patch, suture, and anchor models were constructed, and the Marlow method was used to assign the material properties. Three suturing models were established: 1-knot simple, 1-knot mattress, and 2-knot mattress. The ultimate failure load, failure mode, stress distribution of each structure, and other biomechanical results of the different models were calculated and compared.

Results

The ultimate failure load of the 1-knot mattress suture (71.3 N) was 5.6 % greater than that of the 1-knot simple suture (67.5 N), while that (81.5 N) of the 2-knot mattress was 14.3 % greater than that of the 1-knot mattress. The stress distribution on the patch and supraspinatus tendon was concentrated on suture perforation. Failure of the bridging reconstruction mainly occurred at the suture perforation of the patch, and the damage forms included cutting-through and isthmus pull-out.

Conclusion

A finite element model for the patch-bridging reconstruction of MRCTs was established, and patch-bridging restored the mechanical integrity of the rotator cuff. The 2-knot mattress suture was optimal for patch-bridging reconstruction of MRCTs.
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大面积肩袖撕裂补片桥接重建中的最佳缝合技术:有限元分析
目的使用有限元方法构建大面积肩袖撕裂(MRCT)的补片-桥接修复模型,并研究不同缝合方法和结数对术后生物力学的影响。冈上肌腱的全厚缺损和回缩模型模拟了 MRCT。建立了补片、缝合和锚定模型,并使用马洛法分配材料属性。建立了三种缝合模型:单结简单缝合、单结褥疮缝合和双结褥疮缝合。结果单结褥式缝合的终极失效载荷(71.3 N)比单结简式缝合(67.5 N)大 5.6%,而双结褥式缝合的终极失效载荷(81.5 N)比单结褥式缝合大 14.3%。补片和冈上肌腱上的应力分布主要集中在缝线穿孔处。桥接重建的失败主要发生在补片的缝合穿孔处,损伤形式包括切穿和峡部拉断。 结论 建立了 MRCT 补片桥接重建的有限元模型,补片桥接恢复了肩袖的机械完整性。双结褥式缝合是 MRCT 补丁桥接重建的最佳方法。
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来源期刊
CiteScore
3.80
自引率
0.00%
发文量
21
审稿时长
98 days
期刊介绍: The Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilitation and Technology (AP-SMART) is the official peer-reviewed, open access journal of the Asia-Pacific Knee, Arthroscopy and Sports Medicine Society (APKASS) and the Japanese Orthopaedic Society of Knee, Arthroscopy and Sports Medicine (JOSKAS). It is published quarterly, in January, April, July and October, by Elsevier. The mission of AP-SMART is to inspire clinicians, practitioners, scientists and engineers to work towards a common goal to improve quality of life in the international community. The Journal publishes original research, reviews, editorials, perspectives, and letters to the Editor. Multidisciplinary research with collaboration amongst clinicians and scientists from different disciplines will be the trend in the coming decades. AP-SMART provides a platform for the exchange of new clinical and scientific information in the most precise and expeditious way to achieve timely dissemination of information and cross-fertilization of ideas.
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