A Comparison of Open-Construct PEEK Suture Anchor and Non-Vented Biocomposite Suture Anchor in Arthroscopic Rotator Cuff Repair: A Prospective Randomized Clinical Trial

Kim, Jong Ho; Kim, Yang Soo; Park, In; Han, Sang Yup; Jung, Sehoon; Shin, Sang-Jin

doi:10.1016/j.arthro.2019.08.049

Cited by 38 publications

(69 citation statements)

References 31 publications

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“…This is consistent with multiple prior studies. Kim et al 14 and Chahla et al 5 both showed better bone quality and ossification when comparing an open-architecture anchor to a closed-architecture anchor with PEEK material but found no difference in outcomes or retears. Patients in both groups in our cohort had improved patient-reported outcomes and low retear rates.…”

Section: Discussionmentioning

confidence: 98%

“…Other authors have also found no difference in rotator cuff healing when comparing a coil-type anchor to a screwtype anchor. 5,14 Anchor architecture will continue to be evaluated in future studies, and it is difficult to determine if our findings reflect more of differences in anchor material or design. The failure mode may also change with anchor shape.…”

Section: Discussionmentioning

confidence: 98%

See 1 more Smart Citation

Regenesorb and polylactic acid hydroxyapatite anchors are associated with similar osseous integration and rotator cuff healing at 2 years

Pill

McCallum

Tolan

et al. 2021

Journal of Shoulder and Elbow Surgery

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Background: Commercially available suture anchors for rotator cuff repairs can differ significantly in architecture and material. Clinical data on their osseous integration and its effect on patient-reported outcomes is scarce. Preclinical investigations indicated a higher rate of osseous integration for the open-architecture design of the Healicoil Regenesorb anchor than the closed-threaded design of the Twinfix (Smith & Nephew). The purpose of this study was to investigate these 2 anchors with different architecture and material to determine their effect on osseous integration and clinical outcomes after rotator cuff repair. Methods: A prospective randomized controlled trial was performed from 2014 to 2019. Sixty-four patients (39 females, 25 males) with an average age of 58.7 years who underwent arthroscopic rotator cuff repair by one of 4 board-certified, fellowship-trained surgeons were randomized to receive Healicoil Regenesorb (PLGA/ß-TCP/Calcium Sulfate) or Twinfix Ultra HA (PLLA/HA) anchors. Thirty-two patients had Healicoil anchors implanted, and 32 patients had Twinfix anchors implanted. Of the 64 patients, 51 returned at 24 months for computed tomographic (CT) examination (25 Twinfix and 26 Healicoil) to determine osteointegration of the anchors. Patient-reported outcomes, including Penn Shoulder Score (PENN), Western Ontario Rotator Cuff Index, visual analog scale, EQ-5D, Single Assessment Numeric Evaluation, Global Rating of Change, were collected at baseline, 6 weeks, 3 months, 6 months, 12 months, and 24 months. Ultrasonography was used to assess rotator cuff integrity after 6 months. Two board-certified, fellowship-trained orthopedic surgeons, blinded to the type of anchors, analyzed the CT scans to assess the anchor osteointegration at 24 months using a previously published grading scale. Results: There were no differences in demographics, preoperative outcomes, or baseline characteristics such as tear size, number of anchors, Goutallier classification, or smoking status between groups. There was no difference in osseous integration between the 2 anchors at 24 months (P ¼ .117). Eight patients had rotator cuff retears, of which 2 patients had Twinfix anchors and 6 patients had Healicoil anchors (P ¼ .18). There were no statistically significant differences in patient-reported outcomes or complications between groups. The 2-year PENN scores were 89 with the Twinfix and 88 with Healicoil anchors (P ¼ .55).

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 98%

Regenesorb and polylactic acid hydroxyapatite anchors are associated with similar osseous integration and rotator cuff healing at 2 years

Pill

McCallum

Tolan

et al. 2021

Journal of Shoulder and Elbow Surgery

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show abstract

“…These were comparable in terms of failed healing rate (13.2% vs. 15.0%), perianchor cyst formation (60.5% vs. 60.0%), and major anchor-related complications evaluated by radiology at 6.3 ± 0.9 and 7.8 ± 1.2 postoperative months, respectively. In the follow-up study, the formation of perianchor cyst decreased with time and was observed only in 7 patients (18.4%) at 18 months after surgery [ 25 , 27 ] On the other hand, Shin et al reported that the bony ingrowth into PEEK anchors occurred two times faster than biocomposite anchors [ 28 ]. The PEEK anchor used in the study was newly developed and open-vented to facilitate bony ingrowth.…”

Section: Discussionmentioning

confidence: 99%

Clinical and Radiologic Outcomes of Combined Use of Biocomposite and PEEK Suture Anchors during Arthroscopic Rotator Cuff Repair: A Prospective Observational Study

Lee

2020

JCM

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The aim of the current study was to evaluate the functional and radiologic outcomes of biocompatible non-absorbable PEEK (polyetheretherketone) and biocomposite (poly-L-lactic acid/poly(lactic-co-glycolic acid) 70% + β-tricalcium phosphate) anchors, especially in terms of perianchor cyst formation during the first six months postoperatively. We prospectively analysed 29 patients who underwent arthroscopic rotator cuff repair between March and May 2019. Both PEEK and biocomposite suture anchors were used as lateral anchors in one body. Clinical outcomes were assessed using the shoulder range of motion (ROM), visual analogue scale (VAS) for pain and satisfactory score, American Shoulder and Elbow Surgeons (ASES) score, and Simple Shoulder Test (SST). All these were obtained in patients preoperatively at 3 and 6 months after surgery. The imaging evaluation included perianchor cyst formation, anchor absorption, repaired cuff integrity, and retear pattern. All functional outcomes significantly improved over time. The biocomposite anchor had a statistically significant tendency to form higher grades of fluid collection at 3 months after surgery. However, the perianchor cyst reduced by the sixth postoperative month. Six months postoperatively, the functional outcomes were improved after rotator cuff repair and similar degrees of perianchor cyst formation were observed, regardless of the suture anchor material used.

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“…Ó 8 However, because of limitations of the current study design, it is unclear whether the PEEK composition or the open anchor design was primarily responsible for the observed differences, as well as whether this increased osseous integration affects anchor pullout strength, tuberosity remodeling, and, ultimately, rates of secondary rotator cuff retear or other clinically significant outcomes.…”

Section: See Related Article On Page 389mentioning

confidence: 81%

“…Despite these early conclusions, it is interesting to note that the preponderance of studies suggest equivalent patient-report outcomes irrespective of modern suture design, even for newer generation all-suture constructs. 8,9 In fact, the true merits of increased bony ingrowth and limited osteolysis may only be realized at the time of revision rotator cuff repair, during which prior implant position or secondary cystic change may further dictate suture anchor design, size, and placement.…”

Section: See Related Article On Page 389mentioning

confidence: 99%

Editorial Commentary: Taking a “PEEK” at Suture Anchor Composition following Arthroscopic Rotator Cuff Repair: Is Bio Really Better?

Scholten

Waterman

2020

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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The advent of modern suture anchor technology has not only revolutionized arthroscopic treatment options for management of complex shoulder pathology, but also engendered a materials science quest to identify the ultimate composition and design. What began as an open procedure with transosseous suture fixation has evolved dramatically with the widespread adoption of an arthroscopic, anchor-based technique for rotator cuff repair. Currently, a litany of commercially available "hard" and "soft" anchors are flooding the market, with limited qualitative comparisons to suggest superiority of one type. Ideally, suture anchor design should permit preservation of native glenohumeral bone stock with gradual osseointegration, limit disruption of local tissue homeostasis, and maintain time-zero mechanical strength until soft-tissue healing has occurred. At present, a vented, open-anchor architecture may facilitate better biologic incorporation with increased bony ingrowth through access to marrow elements, although these radiographic advantages have not conferred any clinically meaningful differences for our rotator cuff repair patients. For anchor composition, the jury is still out, and we need to continue to critically evaluate for perianchor cyst formation and longer term remodeling. In fact, the true merits of increased bony ingrowth and limited osteolysis may only be realized at the time of revision rotator cuff repair, during which prior implant position or secondary cystic change may further dictate suture anchor design, size, and placement.

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A Comparison of Open-Construct PEEK Suture Anchor and Non-Vented Biocomposite Suture Anchor in Arthroscopic Rotator Cuff Repair: A Prospective Randomized Clinical Trial

Cited by 38 publications

References 31 publications

Regenesorb and polylactic acid hydroxyapatite anchors are associated with similar osseous integration and rotator cuff healing at 2 years

Regenesorb and polylactic acid hydroxyapatite anchors are associated with similar osseous integration and rotator cuff healing at 2 years

Clinical and Radiologic Outcomes of Combined Use of Biocomposite and PEEK Suture Anchors during Arthroscopic Rotator Cuff Repair: A Prospective Observational Study

Editorial Commentary: Taking a “PEEK” at Suture Anchor Composition following Arthroscopic Rotator Cuff Repair: Is Bio Really Better?

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