Patellar tendon rüptürlerinde tamir ve augmentasyon tekniklerinin biyomekanik karşılaştırılması

Year 2018, Volume: 51 Issue: 1, 33 - 39, 30.03.2018

Abdullah İyigün , Onur Kocadal Mehmet Akif İyidiker Ismail murad Pepe , Onur Kızılay , Tevfik Demir Cem Nuri Aktekin

Abstract

AMAÇ: Bu çalışmanın amacı patellar
tendonun farklı tamir ve augmentasyon tekniklerinin biyomekanik olarak
karşılaştırılmasıdır.

YÖNTEM: Biyomekanik test, 60 adet dana dizi
ile gerçekleştirildi. Dizler tenotomi sonrası titanyum sütür ankor ve polyester
sütür ile Krackow ve modifiye Kessler sütürasyon yapılarak transosseoz tünel
tekniği ile tamir edildi. Augmentasyon için Ethibond, Dall-Miles kablo ve tel
serklaj kullanıldı. Her bir örnek, siklik yüklenme ve statik çekme ile
biyomekanik olarak değerlendirildi.

BULGULAR: Primer tamir gruplarının
karşılaştırılmasında, Krackow sütür ile transosseoz tamir grubunda anlamlı
olarak daha düşük siklik uzama değerleri kaydedildi (p <0.05). Dall-Miles
kablosu veya serklaj teli ile augmentasyon yapılanlarda diğer gruplara göre
daha düşük siklik uzama ve daha yüksek maksimal gerilme kuvveti değerleri
ölçüldü. Augmentasyon grupları, augmentasyon yapılmayan gruplardan daha yüksek
maksimal gerilme direnci ve daha düşük gap oluşumu sergilemiştir.

ÇIKARIMLAR: Patellar tendon yırtıklarının tedavisinde
kullanılan augmentasyon teknikleri tespitin stabilitesini kuvvetlendirmektedir.
Dall-Miles kablosu veya serklaj teli ile augmente edilen transosseoz onarımın
biyomekanik olarak en stabil teknik olduğu söylenebilir.

Keywords

patellar tendon rüptürü; transosseoz onarım; augmentasyon; biyomekanik

Biomechanical comparison of repair and augmentation techniques in patellar tendon ruptures

Abstract

PURPOSE: The aim of this study is to
biomechanically compare the augmentation techniques used in the surgical
treatment of patellar tendon ruptures.

MATERIAL AND METHODS: The study
was carried out with sixty fresh-frozen bovine knees. Patellar tendon repair
was performed with transosseous repair with Krackow or modified - Kessler
suturing or suture anchor repair techniques. Dall-Miles cable, cerclage wire or
polyester suture material was used for augmentation. each specimen was
evaluated biomechanically by cyclic loading and static pullout tests.

RESULTS: Significantly lower cyclic
elongation values were recorded in the transosseous repair with Krackow suture
group (p <0.05) in the comparison of primary repair groups. Lower cyclic
elongation and higher maximal tensile strength values were measured in the
augmentation with Dall-Miles cable or cerclage wire groups than the other
groups. Augmentation groups had higher maximal tensile strength values and
lower gap formation than non-augmented groups.

CONCLUSIONS: In the
surgical treatment of patellar tendon ruptures, augmentation biomechanically
strengthens the initial stability of primary repair.   The transosseous
repair augmented with the Dall-Miles cable or cerclage wire can be said to be
the most biomechanically stabilizing technique.

Keywords

patellar tendon ruptures; transosseous repair; augmentation; biomechanics

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