Exploring Various Labral Reconstruction Techniques in an Ovine Hip Model: A Biomechanical Perspective

Selahaddin Aydemir, Cagri Havitcioglu, Eren Akin, Mustafa Celtik, Firat Aydin, R. Bugra Husemoglu, Onur Hapa
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Abstract

Background: Labral reconstruction using various graft materials, including autografts and allografts, is gaining popularity to address labral deficiencies. However, the biomechanical effects of graft size, type, and fixation techniques remain underexplored. Purpose/Hypothesis: The purpose was to evaluate the effects of graft size, graft type, tubularization, and anchor number on suction seal force and distractive stability in an ovine hip model. It was hypothesized that larger graft sizes and the use of allografts would improve the suction seal force and distractive stability compared with smaller grafts and fewer anchor numbers, while tubularization would have no significant effect. Study Design: Controlled laboratory study. Methods: A total of 40 sheep hip joints were randomly assigned to 5 groups. Labral excision was performed, followed by reconstruction using autografts or allografts. Ovine extensor tendons were chosen as autografts, whereas labrums from a different ovine hip were used for allografts. For group 1, autografts matching the original labral width were used. For group 2, autografts twice the original labral width were used. For group 3, allografts matching the original labral width were harvested from a different ovine hip. For group 4, autografts matching the original width were fixed with only 2 anchors. For group 5, autografts matching the original width were tubularized before use. Suction seal force was measured before and after reconstruction using an electromechanical testing system. Statistical analyses included Mann-Whitney U and Wilcoxon signed-rank tests ( P < .05). Results: Group 2 showed the highest improvement in suction seal force, outperforming all other groups ( P < .01). Group 4 exhibited the lowest distractive stability among all groups. Tubularization (group 5) did not enhance biomechanical performance ( P = .752). Group 3, reconstructed with an allograft, exhibited suction seal performance most closely approximating that of group 2, with no significant difference between them. Conclusion: The data from the ovine cadaveric model indicate that increasing the graft size enhances the suction sealing force; however, it remains below the measurements observed in an intact labrum. Furthermore, increasing the number of anchors and optimal graft selection improve postoperative biomechanical stability. Clinical Relevance: Optimizing graft size and fixation techniques in labral reconstruction may improve joint stability and suction seal function and may support surgical strategies aimed at improving outcomes and delaying the progression of osteoarthritis in patients with labral defects.
从生物力学角度探讨绵羊髋关节模型中各种唇部重建技术
背景:使用各种移植物材料,包括自体移植物和同种异体移植物,来修复阴唇缺损正越来越受欢迎。然而,移植物大小、类型和固定技术的生物力学影响仍未得到充分研究。目的/假设:目的是评估移植物大小、移植物类型、管状化和锚定数量对羊髋关节模型吸合力和牵张稳定性的影响。假设与较小的移植物和较少的锚点数量相比,较大的移植物尺寸和使用同种异体移植物可以提高吸力和牵张稳定性,而管状化则没有显著影响。研究设计:实验室对照研究。方法:将40只绵羊髋关节随机分为5组。切除下唇,然后用自体移植物或同种异体移植物重建。羊伸肌腱被选择作为自体移植物,而来自不同羊髋关节的唇瓣被用于异体移植物。组1采用匹配原唇宽的自体移植物。第二组采用两倍于原唇宽的自体移植物。对于第3组,从不同的绵羊臀部取与原始唇宽匹配的同种异体移植物。对于第4组,匹配原宽度的自体移植物仅用2个锚钉固定。第5组在使用前将与原宽度相匹配的自体移植物进行管状处理。利用机电测试系统测量了改造前后的吸入密封力。统计分析采用Mann-Whitney U和Wilcoxon sign -rank检验(P < 0.05)。结果:第2组吸力密封力改善幅度最大,优于其他各组(P < 0.01)。第4组的注意力分散稳定性最低。管化(第5组)没有提高生物力学性能(P = 0.752)。同种异体移植重建组3的吸力密封性能与组2最接近,两者之间无显著差异。结论:羊尸体模型的数据表明,增大移植物的尺寸可以增强吸力;然而,它仍然低于在完整唇部观察到的测量值。此外,增加锚钉数量和优化移植物选择可改善术后生物力学稳定性。临床意义:优化移植物大小和固定技术在唇部重建中可以改善关节稳定性和吸引密封功能,并可能支持旨在改善结果和延缓唇部缺损患者骨关节炎进展的手术策略。
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