Labral Augmentation With Either Iliotibial Band Allograft or Dermis Allograft Perform Similarly Regarding Peak Force, Displacement, and Work to Labral Repair in Suction Seal Restoration: A Biomechanical Study

IF 4.4 1区 医学 Q1 ORTHOPEDICS
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引用次数: 0

Abstract

Purpose

To investigate whether allograft substitutes may be used to restore suctional seal properties with labral augmentation, the purpose of the current study was to evaluate the biomechanical properties of the labral suction seal under several scenarios, including: (1) intact labrum, (2) rim preparation, (3) labral repair, (4) labral augmentation with iliotibial band (ITB), and (5) labral augmentation with a dermis allograft.

Methods

Eleven hemi-pelvises were dissected to the level of the labrum and placed in a material testing system for biomechanical axial distraction. Each specimen was compressed to 250 newtons (N) and distracted at 10 mm/s while load, crosshead displacement, and time were continuously recorded. For each of the 5 labral states, 3 testing repetitions were performed. Peak force (N, newtons), displacement at peak force (mm, millimeter), and work (N-mm, newton, millimeter) were calculated and normalized to the intact state of each specimen.

Results

Eleven specimens were tested and 8 specimens (age: 58.6 ± 5.4 years, body mass index: 28.6 ± 6.8 kg/m2; 4 female patients; 5 right hips) were included in final analyses. Expressed as a percentage relative to the intact state, the average normalized peak force, displacement at peak force, and work for each labral state were as follows: intact (100.0% ± 0% for all), rim preparation (89.0% ± 9.2%, 93.3% ± 20.6%, 85.1% ± 9.0%), repair (61.3% ± 17.9%, 88.4% ± 36.9%, 58.1% ± 16.7%), ITB allograft (62.7% ± 24.9%, 83.9% ± 21.6%, 59.4% ± 22.4%), and dermis allograft (57.8% ± 27.2%, 88.2% ± 29.5%, 50.0% ± 20.1%). Regarding peak force, intact state was significantly greater compared with the labral repair, augmentation with ITB, and augmentation with the dermis allograft states (P < .001). No significant differences were demonstrated between displacement at peak force (P = .561). Regarding work, both intact state and rim preparation states were significantly greater than the repair, ITB augmentation, and dermis allograft augmentation states (P < .001). In all outcome measures, the dermis allograft augmentation performed with no statistical difference to the ITB augmentation state.

Conclusions

Labral repair and labral augmentation with either ITB allograft or the dermis allograft resulted in significantly lower peak force and work to equilibrium compared with the intact and rim prep states. There was no statistical difference between repair and augmentation states as well as no statistical difference between ITB allograft and dermal allograft at time zero.

Clinical Relevance

This study compares biomechanical properties of the suction seal of the hip comparing labral states including intact, rim preparation, repair, and augmentation, which can be used for surgical decision-making.
使用髂胫带同种异体移植或真皮同种异体移植进行髋臼瓣增厚,在吸脂修复中与髋臼瓣修复的峰值力、位移和功表现相似:生物力学研究
目的为了研究是否可以使用同种异体移植替代物来恢复唇瓣增厚术的吸力密封特性,本研究旨在评估几种情况下唇瓣吸力密封的生物力学特性,包括:(1) 完整唇瓣,(2) 唇缘准备,(3) 唇瓣修复,(4) 用髂胫束(ITB)增厚唇瓣,(5) 用真皮同种异体移植增厚唇瓣。方法将 11 个半骨盆解剖至唇缘水平,并将其放置在材料测试系统中进行生物力学轴向牵拉。每个样本被压缩至 250 牛顿(N),并以 10 毫米/秒的速度牵拉,同时连续记录载荷、十字头位移和时间。对 5 种唇缘状态中的每一种状态都进行了 3 次重复测试。计算峰值力(牛顿、牛顿)、峰值力时的位移(毫米、毫米)和功(牛顿-毫米、牛顿、毫米),并与每个试样的完整状态进行归一化:28.6 ± 6.8 kg/m2;4 名女性患者;5 个右髋)纳入最终分析。以相对于完好状态的百分比表示,每种唇缘状态下的平均归一化峰值力、峰值力位移和功如下:完好(全部为 100.0% ± 0%)、唇缘准备(89.0% ± 9.2%、93.3%±20.6%、85.1%±9.0%)、修复(61.3%±17.9%、88.4%±36.9%、58.1%±16.7%)、ITB 异体移植(62.7%±24.9%、83.9%±21.6%、59.4%±22.4%)和真皮异体移植(57.8%±27.2%、88.2%±29.5%、50.0%±20.1%)。就峰值力而言,与唇瓣修复、使用 ITB 增强和使用真皮同种异体移植增强的状态相比,完整状态的峰值力明显更大(P < .001)。峰值力位移之间没有明显差异(P = .561)。在做功方面,完整状态和边缘准备状态都明显大于修复、ITB 增强和真皮同种异体移植增强状态(P < .001)。结论与完好状态和边缘准备状态相比,使用 ITB 同种异体移植物或真皮同种异体移植物进行髋关节修复和髋臼增厚手术所产生的峰值力和平衡功明显较低。修复和增厚状态之间没有统计学差异,ITB同种异体移植和真皮同种异体移植在零时也没有统计学差异。 临床意义这项研究比较了髋关节吸脂密封的生物力学特性,比较了包括完整、边缘准备、修复和增厚在内的唇瓣状态,可用于手术决策。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
9.30
自引率
17.00%
发文量
555
审稿时长
58 days
期刊介绍: Nowhere is minimally invasive surgery explained better than in Arthroscopy, the leading peer-reviewed journal in the field. Every issue enables you to put into perspective the usefulness of the various emerging arthroscopic techniques. The advantages and disadvantages of these methods -- along with their applications in various situations -- are discussed in relation to their efficiency, efficacy and cost benefit. As a special incentive, paid subscribers also receive access to the journal expanded website.
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