Clinics in Shoulder and Elbow

Korean Shoulder and Elbow Society (대한견·주관절의학회)
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Is the UU Stitch Really Alternative to Modified MA (Mason-Allen) Stitch for Rotator Cuff Repair? - Biomechanical Comparative Study of UU to Modified MA Stitch -

회전근 개 파열의 봉합에서 UU 봉합법은 변형된 MA(Mason-Allen) 봉합법을 대치할 수 있는가? - UU 봉합법과 변형된 MA 봉합법의 생역학적 비교-

  • Friedman, Darren J (NYU Hospital for Joint Diseases, NYU School of Medicine) ;
  • Ko, Sang-Hun (Department of Orthopedic Surgery, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Park, Ki-Bong (Department of Orthopedic Surgery, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Jun, Hyung-Min (Department of Orthopedic Surgery, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Kim, Tae-Won (Department of Orthopedic Surgery, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Lim, Hyun-Woo (School of Medical and Automotive Engineering, Ulsan University) ;
  • Yum, Young-Jin (School of Medical and Automotive Engineering, Ulsan University)
  • ;
  • 고상훈 (울산대학교 의과대학 울산대학교병원 정형외과) ;
  • 박기봉 (울산대학교 의과대학 울산대학교병원 정형외과) ;
  • 전형민 (울산대학교 의과대학 울산대학교병원 정형외과) ;
  • 김태원 (울산대학교 의과대학 울산대학교병원 정형외과) ;
  • 임현우 (울산대학교 공과대학 기계자동차 공학부) ;
  • 염영진 (울산대학교 공과대학 기계자동차 공학부)
  • Published : 2009.12.15
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Abstract

Purpose: In arthroscopic rotator cuff repairs there are generally weak link in tendon suture interface, arthroscopic rotator cuff repairs can have higher retear rates than open repairs. The purpose of this study was to compare the strength of UU (Ulsan University) suture than open modified MA (Mason-Allen) suture when suture anchored into bone. Materials and Methods: The human supraspinatus tendons were harvested from the shoulder of the cadaver and split in 2 times, producing four tendons per one shoulder, for a total of 24 specimens. Two suture configurations (UU, MA) were randomized and checked on each set of tendons. Specimens were cyclically loaded under force control between 5 and 30 N at 0.25 Hz for fifty cycles. Each specimen was loaded to failure under displacement control at 1 mm/sec. Cyclic elongation, peak to peak displacement, stiffness, ultimate tensile load, mode of failure were checked. Results: No significant difference was found between two suture configuration with respect to peak to peak displacement, cyclic elongation, and stiffness. With regard to ultimate failure load, there were no significant difference statistically between the UU suture and modified MA suture (109.4 N, 110.6 N). The most common mode of failure between both sutures was suture pull-out through the tendon. Conclusion: The UU suture and modified MA suture produced similar biomechanical properties.

목적: 관절경 하 회전근 개 봉합에서 일반적으로 건-봉합간 접촉면 (tenon-suture interface) 에 약한부위 (weak link)가 형성되어 있어 관절경 하 회전근 개 봉합은 개방적 봉합술보다 높은 재파열율을 가진다. 이 연구의 목적은 봉합사를 뼈에 고정할 때 관절경으로 사용할 수 있는 UU (Ulsan University) 봉합과 개방적 변형 MA (Mason-Allen) 봉합의 강도를 비교하는 것이다. 대상 및 방법: 한 구의 사체 극상근 건을 채취하여 절반으로 나눈 후 다시 절반을 나누어 사체의 어깨 관절 한 구당 네 개의 건을 만들어 총 24개의 검체를 만들었다. 두 봉합 형태 (UU, MA)는 무작위로 선택하였으며 각각의 건에 시행하였다. 검체는 0.25 Hz에서 5~30N의 조절된 외력하에서 50회 주기 부하 (cyclic loading)를 받았다. 각 검체는 초당 1mm의 전이가 되는 상황하에서 파열이 발생할 때(ultimate tensile load)까지 부하를 받았다. 조건 이완 (condition elongation), peak-to-peak 전이(displacement), 기울기 (stiffness), 최대 인장력 (ultimate tensile load), 파열 양상 (mode of failure) 등을 기록하였다. 결과: 주기 부하 실험에서 두 봉합 형태 간 유의 있는 차이는 없었다. 최대 장력 실험에서 UU 봉합과 변형 MA (Mason-Allen) 봉합 간에 통계학적으로 유의한 차이는 없었다 (109.4 N, and 110.6 N). 양 봉합 형태에서 가장 흔한 파열 양상은 봉합의 빠짐 (suture pull-out)이었다. 결론: UU 봉합과 변형 MA 봉합은 유사한 생역학적 특성을 가진다.

Keywords

References

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