ABSTRACT
Objective: To clarify the value of the cortical endo-button as an internal fixator in Latarjet procedure through biomechanical analysis. Methods: Ten pairs of shoulder joints from 6-7 months old male pigs were selected. Each pair was randomly divided into screw group and endo-button group. A 25% glenoid defect model was created, and the porcine infraspinatus tendon and its associated bone were used to simulate conjoint tendon and coracoid process in human body. The bone grafts were fixed with two 3.5 mm screws and double cortical endo-buttons with high-strength sutures in screw group and endo-button group, respectively. The prepared glenoid defect model was fixed on a biomechanical test bench and optical markers were fixed on the glenoid and the bone block, respectively. Then fatigue test was performed to observe whether the graft or internal fixator would failed. During the test, the standard deviations of the relative displacement between the graft and the glenoid of two groups were measured by optical motion measure system for comparison. Finally the maximum failure load comparison was conducted and the maximum failure loads of the two groups were measured and compared. Results: There was no tendon tear, bone fracture, and other graft or internal fixation failure in the two groups during the fatigue test. The standard deviation of the relative displacement of the screw group was (0.007 87±0.001 44) mm, and that of the endo-button group was (0.034 88±0.011 10) mm, showing significant difference between the two groups ( t=7.682, P=0.000). The maximum failure load was (265±39) N in screw group and (275±52) N in endo-button group, showing no significant difference between the two groups ( t=1.386, P=0.199). There were 3 ways of failure: rupture at bone graft's tunnel (6/10 from screw group, 3/10 from endo-button group), tendon tear at the cramp (2/10 from screw group, 2/10 from endo-button group), and tendon tear at the internal fixator interface (2/10 from screw group, 5/10 from endo-button group), showing no significant difference between the two groups ( P=0.395). Conclusion: Although the endo-button fixation fails to achieve the same strong fixation stability as the screw fixation, its fixation stability can achieve the clinical requirements. The two fixation methods can provide similar fixation strength when being used in Latarjet procedure.
ABSTRACT
Objective To explore the clinical effect of arthroscopic repair without traction for non-osseous Bankart injury.Methods From January 2009 to January 2015,the clinical data of 182 cases underwent arthroscopic Bankart repair for anterior shoulder instability in our hospital were analyzed retrospectively.They were aged from 18 to 39 years old,mean age was(26.5 ± 9.3) years.The course of disease was from 1 to 10 years,mean duration was(3.2 ±2.6) years.Recurrent dislocation was 6 to 62 times,with average of (24.2 ± 17.3) times.All cases were performed arthroscopic repair without traction.Rowes scores and UCLA scores were used for evaluation.Results All of 182 cases were followed up from 6 to 18 months,an average of (12.5 ± 6.7) months.Of the 182 patients,12 cases with postoperative limited 20°external rotation could not attend confrontational training and the other 170 cases had no adverse effect.The average loss of shoulder joint extorsion activity angle were (10.5 ± 4.1) °.Postoperative UCLA score (89 ± 3.5) was more than preoperative (25 ± 6.2),the differences were significant (P ＜ 0.05).Postoperative Rowes score (28.7 ± 2.2) were more than preoperative (7.3 ± 1.6),the differences were significant (P ＜ 0.05).Conclusion Curative effect of arthroscopic repair without traction for non-osseous Bankart injury caused by training is satifactory,which can provide brachial plexus,blood vessel and other tissues during surgery from traction,and be helpful to the popularization and application in basic-level hospitals.
ABSTRACT
PURPOSE: To assess the feasibility of ultrasound-guided intraarticular contrast injection using the posterior approach for MR arthrography. MATERIALS AND METHODS: Between June 2002 and October 2004, 132 patients (29 female, 103 male: mean age, 33.6 years) underwent ultrasound-guided intraarticular contrast media injection (40 ml saline+10 ml 2% lidocaine(R)+0.2 ml gadopentetate dimeglumine+0.4 ml epinephrine(R) for MR arthrography. The patients were classified into four groups, viz. the no leakage group, the minor leakage with successful intraarticular injection group, the major leakage with unsuccessful intraarticular injection group, and the injection failure group. RESULTS: The "no leakage" and "minor leakage" groups were considered to be technical successes, while the "major leakage" and "injection failure" groups were regarded as technical failures. The technical success rate of ultrasound-guided intraarticular contrast injection using the posterior approach for MR Arthrography was 99.2% (131/132 patients) and one patient 0.7% (1/132 patients) was included in the "major leakage" group. CONCLUSION: Ultrasound-guided intraarticular contrast injection using the posterior approach for MR arthrography was feasible with a high success rate.