Analyse biomécanique d’une plaque de fixation des butées de type Latarjet

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• 作者：Rachel Frank¹ ; Nicole Fischer² ; Franziska Reifenschneider² ; Stefanie Ficht² ; Tim Hubner² ; Coen Wijdicks² ; Alberto Costantini³ ; Giovanni Di Giacomo³ ; Anthony Romeo¹ ; ^{anthony.romeo@rushortho.com" class="auth_mail" title="E-mail the corresponding author}
• 刊名：Revue de Chirurgie Orthopédique et Traumatologique
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：102
• 期：8_supp_S
• 页码：S279
• 全文大小：51 K

文摘

The use of a mini-plate for coracoid fixation during the Latarjet procedure has recently been described, with encouraging radiographic outcomes. The purpose of this study was to determine the biomechanical properties of mini-plate fixation for the Latarjet procedure, and to compare these findings to various screw fixation configurations.

Materials and methods

Eight fixation groups (n = 5 specimens per group) were tested at a screw insertion angle of 0° including I) 3.75 mm single-screw, II) 3.75 mm double-screw, III) 3.75 mm double-screw with washers, IV) 3.75 mm double-screw with mini-plate, V) 4.00 mm single-screw, VI) 4.00 mm double-screw, VII) 4.00 mm double-screw with washers, and VIII) 4.00 mm double-screw with mini-plate. In addition, for groups I-III and V–VII, 30 additional specimens (n = 5 per group) were tested at a screw insertion angle of 15° (groups IX–XIV). To maintain specimen uniformity, rigid polyurethane foam blocks were used. For all specimens, testing parameters included a preload of 214 N for 10 seconds, cyclical loading from 184–736 N at 1 Hz for 100 cycles, and failure loading at a rate of 15 mm/min until 10 mm of displacement or specimen failure occurred (ElectroPuls E10000, Instron, United Kingdom). In addition, a full-field stereo-optical measurement system (ARAMIS, GOM mbH, Germany) was utilized to evaluate graft strain, graft displacement and screw displacement and rotation.

Results

All specimens in groups I and V (single screw constructs) and 77% of specimens within groups IX–XIV (screw insertion angle of 15°) failed prior to the completion of cyclical loading; all but one of the other specimens survived and underwent maximum load to failure testing (1 specimen in group VII failed). Across all groups, group VIII (4.00 mm; plate) demonstrated the highest maximum failure load (P > 0.001), averaging loads 770 N higher than the next highest group (P > 0.001). There was no significant difference in displacement during cycling between specimens with plate fixation (groups V and VIII, P > 0.05). All specimens in groups IX–XIV (insertion angle of 15°) had significant lower maximum loads to failure compared to their specimens in groups II, II, IV, VI, VII, and VIII, respectively (P > 0.001 for all).

Conclusions

This is the first study to report on the biomechanical properties of the mini-plate for coracoid fixation in the Latarjet procedure. The results indicate significantly superior failure loads with the mini-plate compared to other constructs, which may have clinical implications, particularly in the high-demand contact athlete. Clinical studies with analysing patient outcomes and failure rates are necessary to determine the clinical implications of these biomechanical findings.