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CC BY-NC-ND 4.0 · Revista Chilena de Ortopedia y Traumatología 2021; 62(03): e159-e167
DOI: 10.1055/s-0041-1740546
Artículo Original | Original Article

Mayor presión y área de contacto en reparación transósea cruzada de Manguito Rotador versus reparación simple

Article in several languages: español | English
Julio José Contreras
1   Instituto Traumatológico, Santiago, RM, Chile
,
Rodrigo Liendo
2   Pontificia Universidad Católica de Chile, Santiago, RM, Chile
,
Francisco Soza
2   Pontificia Universidad Católica de Chile, Santiago, RM, Chile
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Resumen

Objetivo Comparar la presión y el área de contacto en la interfase tendón-huella de una reparación realizada con suturas transóseas simples y cruzadas.

Métodos Se utilizaron doce hombros de cordero para simular una rotura de manguito rotador. Se midió el área de contacto en la interfase tendón-huella con láminas sensibles a presión; luego, se midió la presión con un sensor digital. Se registró la presión basal durante la aplicación de carga cíclica y al final de la intervención. Se compararon 2 reparaciones: 2 túneles transóseos con nudos simples (TOS; n = 6) y 2 túneles transóseos con nudos cruzados (TOC; n = 6), utilizando FiberWire #2. Se realizaron 1.400 ciclos, con una frecuencia 2,5 Hz y una carga de 5 N. Se utilizó la prueba de Mann-Whitney, y ae consideraron significativos valores de p < 0,05.

Resultados La reparación TOS presentó un 50,9 ± 12,7% de distribución de presiones en comparación con 72,2 ± 5,3% en la reparación TOC (p < 0,009). La presión promedio en la reparación TOS fue 0,7 ± 0,1 MPa en comparación con 1,1 ± 0,2 MPa en la reparación TOC (p < 0,007). La reparación TOS registró una presión basal de 5,3 ± 5,3 N, presión final de 3,8 ± 4,6 N, y una variación de 51,7 ± 38%. La reparación TOC registró una presión basal de 10,7 ± 1,8 N, presión final de 12,9 ± 8,7 N, y una variación de 114,9 ± 65,9% (p < 0,044; p < 0,022; y p < 0,017, respectivamente).

Conclusión La reparación TOC presenta mayor presión a nivel de la interfase tendón-hueso, menor pérdida de fuerza de contacto ante cargas cíclicas, y una mejor distribución de fuerza en la huella al comparar con la reparación TOS, lo que se podría traducir en mejor cicatrización tendínea.

Nivel de Evidencia Estudio de ciencia básica.

Palabras Clave

manguito de los rotadores - presión - sutura - técnicas de sutura - traumatismos de los tendones - tendones


Publication History

Received: 28 June 2020

Accepted: 06 August 2021

Article published online:
22 December 2021

© 2021. Sociedad Chilena de Ortopedia y Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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