经骨隧道的低拉伸强度缝合线和直径大于或等于 5 毫米的缝合锚与髌腱初次修复的较高失败率有关

Q3 Medicine Arthroscopy Sports Medicine and Rehabilitation Pub Date : 2024-02-14 DOI:10.1016/j.asmr.2024.100908

Mark S. Katsma D.O. , Vaughn Land M.D. , S. Hunter Renfro M.D. , Hunter Culp M.D. , George C. Balazs M.D.

{"title":"经骨隧道的低拉伸强度缝合线和直径大于或等于 5 毫米的缝合锚与髌腱初次修复的较高失败率有关","authors":"Mark S. Katsma D.O. , Vaughn Land M.D. , S. Hunter Renfro M.D. , Hunter Culp M.D. , George C. Balazs M.D.","doi":"10.1016/j.asmr.2024.100908","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><p>To determine the rate of and risk factors for clinical failure and return to military duty following primary patellar tendon repair with either transosseous trunnel repair or suture anchor repair.</p></div><div><h3>Methods</h3><p>The Military Health System Data Repository (MDR) was queried to identify all adult patients undergoing surgical treatment of a patellar tendon rupture in the Military Health System from 2014 to 2018. Patients who underwent either transosseous tunnel repair or suture anchor repair were included. Health records were examined to collect additional data. Univariate analysis and multivariate logistic regression models were used to determine independent risk factors for rerupture.</p></div><div><h3>Results</h3><p>A total of 450 knees in 437 patients were included. Transosseous tunnel repair was the most frequently used technique (314/450, 77%), followed by suture anchor repair (113/450, 25%). Rerupture occurred in 33 knees (7%). There was no difference in rerupture rate between transosseous tunnel repair and suture anchor repair (<em>P</em> = .15), and this result persisted within the multivariate logistic regression model. Among transosseous tunnel repairs, use of low tensile strength suture was an independent risk factor for repair failure (odds ratio [OR], 3.4; <em>P</em> = .016). Among suture anchor repairs, use of anchors 5.0 mm in diameter or greater (OR, 12.0; <em>P</em> = .027) was an independent risk factor for repair failure.</p></div><div><h3>Conclusions</h3><p>There is no statistically significant difference in failure rate between transosseous tunnel repair and suture anchor repair in primary patellar tendon ruptures. However, the use of low tensile strength suture with transosseous tunnels and the use of suture anchors 5.0 mm in diameter or greater resulted in significantly higher failure rates. These data suggest that use of high tensile strength suture in transosseous tunnel repair and use of suture anchors less than 5.0 mm in diameter in suture anchor repair result in lower failure rate in primary patellar tendon repair.</p></div><div><h3>Level of Evidence</h3><p>Level III, retrospective cohort study.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"6 2","pages":"Article 100908"},"PeriodicalIF":0.0000,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X24000269/pdfft?md5=10c587973fb95d67d80475e32cd14e5e&pid=1-s2.0-S2666061X24000269-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Low Tensile Strength Suture With Transosseous Tunnels and Suture Anchors 5 mm in Diameter or Greater Are Associated With Higher Failure Rates in Primary Patellar Tendon Repair\",\"authors\":\"Mark S. Katsma D.O. , Vaughn Land M.D. , S. Hunter Renfro M.D. , Hunter Culp M.D. , George C. Balazs M.D.\",\"doi\":\"10.1016/j.asmr.2024.100908\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Purpose</h3><p>To determine the rate of and risk factors for clinical failure and return to military duty following primary patellar tendon repair with either transosseous trunnel repair or suture anchor repair.</p></div><div><h3>Methods</h3><p>The Military Health System Data Repository (MDR) was queried to identify all adult patients undergoing surgical treatment of a patellar tendon rupture in the Military Health System from 2014 to 2018. Patients who underwent either transosseous tunnel repair or suture anchor repair were included. Health records were examined to collect additional data. Univariate analysis and multivariate logistic regression models were used to determine independent risk factors for rerupture.</p></div><div><h3>Results</h3><p>A total of 450 knees in 437 patients were included. Transosseous tunnel repair was the most frequently used technique (314/450, 77%), followed by suture anchor repair (113/450, 25%). Rerupture occurred in 33 knees (7%). There was no difference in rerupture rate between transosseous tunnel repair and suture anchor repair (<em>P</em> = .15), and this result persisted within the multivariate logistic regression model. Among transosseous tunnel repairs, use of low tensile strength suture was an independent risk factor for repair failure (odds ratio [OR], 3.4; <em>P</em> = .016). Among suture anchor repairs, use of anchors 5.0 mm in diameter or greater (OR, 12.0; <em>P</em> = .027) was an independent risk factor for repair failure.</p></div><div><h3>Conclusions</h3><p>There is no statistically significant difference in failure rate between transosseous tunnel repair and suture anchor repair in primary patellar tendon ruptures. However, the use of low tensile strength suture with transosseous tunnels and the use of suture anchors 5.0 mm in diameter or greater resulted in significantly higher failure rates. These data suggest that use of high tensile strength suture in transosseous tunnel repair and use of suture anchors less than 5.0 mm in diameter in suture anchor repair result in lower failure rate in primary patellar tendon repair.</p></div><div><h3>Level of Evidence</h3><p>Level III, retrospective cohort study.</p></div>\",\"PeriodicalId\":34631,\"journal\":{\"name\":\"Arthroscopy Sports Medicine and Rehabilitation\",\"volume\":\"6 2\",\"pages\":\"Article 100908\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-02-14\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S2666061X24000269/pdfft?md5=10c587973fb95d67d80475e32cd14e5e&pid=1-s2.0-S2666061X24000269-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Arthroscopy Sports Medicine and Rehabilitation\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2666061X24000269\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Arthroscopy Sports Medicine and Rehabilitation","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666061X24000269","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}

引用次数: 0

摘要

目的确定经骨隧道修复术或缝合锚修复术进行初级髌腱修复术后临床失败率和重返部队的风险因素。方法查询军事卫生系统数据存储库（MDR），以确定2014年至2018年期间在军事卫生系统接受髌腱断裂手术治疗的所有成年患者。其中包括接受经骨隧道修复术或缝合锚修复术的患者。检查健康记录以收集更多数据。采用单变量分析和多变量逻辑回归模型确定再断裂的独立风险因素。经骨隧道修复是最常用的技术（314/450，77%），其次是缝合锚修复（113/450，25%）。33个膝关节（7%）发生了再断裂。经骨隧道修复术和缝合锚修复术的再断裂率没有差异（P = .15），这一结果在多变量逻辑回归模型中依然存在。在经骨隧道修复中，使用低抗张强度缝线是导致修复失败的独立风险因素（几率比 [OR]，3.4；P = .016）。结论在原发性髌腱断裂中，经骨隧道修复和缝合锚修复的失败率在统计学上没有显著差异。然而，在经骨隧道中使用低抗张强度缝合线以及使用直径为 5.0 毫米或更大的缝合锚会导致明显更高的失败率。这些数据表明，在经骨隧道修复中使用高强度缝合线，在缝合锚修复中使用直径小于 5.0 毫米的缝合锚，可降低原发性髌腱修复的失败率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

Low Tensile Strength Suture With Transosseous Tunnels and Suture Anchors 5 mm in Diameter or Greater Are Associated With Higher Failure Rates in Primary Patellar Tendon Repair

Purpose

To determine the rate of and risk factors for clinical failure and return to military duty following primary patellar tendon repair with either transosseous trunnel repair or suture anchor repair.

Methods

The Military Health System Data Repository (MDR) was queried to identify all adult patients undergoing surgical treatment of a patellar tendon rupture in the Military Health System from 2014 to 2018. Patients who underwent either transosseous tunnel repair or suture anchor repair were included. Health records were examined to collect additional data. Univariate analysis and multivariate logistic regression models were used to determine independent risk factors for rerupture.

Results

A total of 450 knees in 437 patients were included. Transosseous tunnel repair was the most frequently used technique (314/450, 77%), followed by suture anchor repair (113/450, 25%). Rerupture occurred in 33 knees (7%). There was no difference in rerupture rate between transosseous tunnel repair and suture anchor repair (P = .15), and this result persisted within the multivariate logistic regression model. Among transosseous tunnel repairs, use of low tensile strength suture was an independent risk factor for repair failure (odds ratio [OR], 3.4; P = .016). Among suture anchor repairs, use of anchors 5.0 mm in diameter or greater (OR, 12.0; P = .027) was an independent risk factor for repair failure.

Conclusions

There is no statistically significant difference in failure rate between transosseous tunnel repair and suture anchor repair in primary patellar tendon ruptures. However, the use of low tensile strength suture with transosseous tunnels and the use of suture anchors 5.0 mm in diameter or greater resulted in significantly higher failure rates. These data suggest that use of high tensile strength suture in transosseous tunnel repair and use of suture anchors less than 5.0 mm in diameter in suture anchor repair result in lower failure rate in primary patellar tendon repair.