Arthroscopy: The Journal of Arthroscopic & Related Surgery
Original articleA Biomechanical and Radiographic Analysis of Standard and Intracortical Suture Anchors for Arthroscopic Rotator Cuff Repair
Section snippets
Methods
Sixteen human cadaveric humeri (8 pairs) were sectioned at the mid-diaphysis and cleaned of soft tissue (age range, 57 to 81 years). Care was taken not to decorticate the supraspinatus tendon footprint on the humeral head. Bone density was measured with a Lunar Dual-Energy X-Ray Absorptiometry (DEXA) machine (GE Medical Systems, Waukesha, WI). These data revealed a relatively osteoporotic sample population (0.34 ± 0.09 g/cm2) compared with previously reported densities (0.78 g/cm2) for young
Results
There were no significant differences in radiographic measures for angle change (range, 12.6° to 21.3°) (Table 1). The IC anchor had an angle change of 12.6° ± 10.6° and the Super Revo had an angle change of 15.3° ± 21.9°. The TwinFix anchor had an angle of 17.0° ± 15.4° and the FastinRC had an angle change of 21.3° ± 23.8°. There were no significant differences between anchor types for displacement change (range, 1.3 to 2.1 mm). The IC anchor had 1.3 ± 1.3 mm of displacement within the humeral
Discussion
Previous studies have reported adequate to excellent performance of suture anchors used commonly in clinical practice.1, 2, 3, 4, 5, 6, 23, 24 To obtain clinically relevant biomechanical data, the present study used a cyclic load protocol with oblique loads on the suture-anchor construct.
The magnitude of total construct displacement of the suture-anchor construct observed in this study was concerning. The average displacement of the 3 conventional suture-anchor constructs following cyclic
Conclusion
Data from the current study indicate that an IC suture anchor may provide the surgeon with biomechanical stability and failure loads similar to other anchors. The total construct displacements for all anchors represent magnitudes of clinical concern. It is also of clinical concern that anchor motion within the humeral head contributed approximately one third of this total displacement. This type of analysis, with particular focus on the movement of suture anchors within the humeral head,
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Cited by (33)
Novel ultrasound assisted suture anchor system using the BoneWelding® technology yields a comparable primary stability in osteopenic and healthy human humeri as a benchmark anchor
2018, Acta Orthopaedica et Traumatologica TurcicaCitation Excerpt :With an extension rate of 20 mm/min on the crosshead, 50 cycles were performed per tensile load starting at 75 N. Starting from the preload tension at 20 N the anchor system was strained until the 75 N threshold was reached and then the tension was reduced back to the preload of 20 N before initiating the next cycle. After 50 cycles at 75 N, the strain was increased in 25 N steps to 100 N, 125 N, 150 N, etc. until system failure occurred.15–19 The maximum failure loads (Fmax), the initial system displacement at 75 N and the respective modes of failure (anchor dislocation, suture slippage, suture rupture) were recorded.
Suture Anchor Biomechanics after Rotator Cuff Footprint Decortication
2016, Arthroscopy - Journal of Arthroscopic and Related SurgeryHealing disturbance with suture bridge configuration repair in rabbit rotator cuff tear
2016, Journal of Shoulder and Elbow SurgeryArthroscopic Double-Row Rotator Cuff Repair Using a Knotless, Interconnected Technique
2015, Operative Techniques in OrthopaedicsEffect of pretension and suture needle type on mechanical properties of acellular human dermis patches for rotator cuff repair
2012, Journal of Shoulder and Elbow SurgeryImproved time-zero biomechanical properties using poly-L-lactic acid graft augmentation in a cadaveric rotator cuff repair model
2010, Journal of Shoulder and Elbow SurgeryCitation Excerpt :Repairs were tested in air, at room temperature, and kept moist by spraying with saline solution. Repairs were preconditioned with 100 cycles from 5 to 100 N at 0.25 Hz and then immediately tested to failure with uniaxial loading in tension at 30 mm/min.32,33,40 The preconditioning loads were determine to be within physiologic limits for a passive range-of-motion physical therapy program based on electromyographic analysis, magnetic resonance imaging, and ultrasound imaging of rotator cuff muscle volumes.2,25,26,34
Supported by an unrestricted research grant from Arthrex, Inc, Naples, Florida.