Arthrography of the shoulder after operative repair of the torn rotator cuff

Calvert, P; Packer, N. P.; Stoker, Dennis; Bayley, J. I. L.; Kessel, Lipmann

doi:10.1302/0301-620x.68b1.3941132

Cited by 142 publications

(57 citation statements)

References 7 publications

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“…Retear rates reportedly range from 15% to 90% [1,2,11,20], with approximately 4% of failures being attributed to metal anchor pullout from bone at the time of revision surgery [5,6]. The pullout rates for bioabsorbable anchors reportedly are much higher, with as much as 30% of painful shoulders showing anchor pullout on MRI after cuff repair [12].…”

Section: Introductionmentioning

confidence: 99%

“…The purposes of this study were to determine (1) whether augmentation of suture anchor fixation using bioabsorbable tricalcium phosphate cement would increase pullout strength of suture anchors from bone in similar proportion to other applications previously studied; (2) whether said augmentation would increase the number of cycles to failure of suture anchors placed in bone and compare to data from a previous study using PMMA; and (3) the failure mode after said augmentation and again compare to results of a previous study using PMMA [9].…”

Section: Introductionmentioning

confidence: 99%

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Bioabsorbable Tricalcium Phosphate Bone Cement Strengthens Fixation of Suture Anchors

Oshtory¹,

Lindsey

Giori

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Background Failure of suture anchor fixation in rotator cuff repair can occur at different interfaces. Prior studies show fixation at the bone-anchor interface can be augmented using polymethylmethacrylate (PMMA) cement, and screw fixation into bone can be strengthened using bioabsorbable tricalcium phosphate cement. Questions/purposes We wished to determine whether augmentation of suture anchor fixation using bioabsorbable tricalcium phosphate cement would increase pullout strength of suture anchors from bone and the number of cycles to failure, to determine the mode of failure after cement augmentation, and to compare strength and mode of failure with those after augmentation with PMMA.Methods We used 10 matched pairs of cadaveric proximal humeri and implanted a metal screw-type suture anchor in one side and on the other side injected tricalcium phosphate cement into the anchor holes before anchor placement. We tested all specimens to failure using a ramped cyclic loading protocol. Results Tricalcium phosphate cement augmentation increased the final load to failure by 29% and the number of cycles to failure by 20%. Visual inspection confirmed that failure occurred at the cement-bone interface. Conclusions Tricalcium phosphate cement appears to augment suture anchor fixation into bone, reducing the risk of anchor pullout and failure. Clinical Relevance When relying on suture anchor fixation in bone of questionable quality, we suggest considering augmentation of suture anchor fixation with bioabsorbable cement. This method also provides potential for bioabsorbability and may be more amenable to arthroscopic application.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Bioabsorbable Tricalcium Phosphate Bone Cement Strengthens Fixation of Suture Anchors

Oshtory¹,

Lindsey

Giori

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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“…It would seem that restoration of the physiological tension of the rotator ligaments is essential (Patte et al 1981;Packer et al 1983;Calvert et al 1986;Post 1990).…”

Section: Discussionmentioning

confidence: 99%

Operative release of the impingement syndrome

Hartwig

Burkhard

1996

Arch Orthop Trauma Surg

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We examined the long-term results of two different methods of shoulder decompression (Neer acromioplasty and resection of the coracoacromial ligament) after an average observation period of 8 years. Clinical and radiological features were evaluated in 48 patients with 50 treated shoulders, as was the subjective result of the treatment in 58 patients with 61 operated joints. Pain was substantially eased in 93% (acromioplasty) and 100% (ligamentary resection), mobility improved in 76% and 83%, respectively. A favourable result was achieved in 86% of the acromioplasty cases and in 75% of the ligament resection cases. In one-third of the shoulders, an increasing degeneration of joint structures could be demonstrated radiologically; the degree depended on the severity of the initial rotator cuff injury, not on the method of shoulder decompression. The differences between both surgical methods examined were not statistically significant, but acromioplasty provides a superior extension of the subacromial space and protection for the reconstructed rotator cuff tendons. Our results compare favourably with other published studies. The methods described are suitable for the treatment of subacromial impingement.

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“…An interesting twist on the topic of soft tissue fixation is the finding, by independent investigators, of postoperative defects in repaired rotator cuffs that were functioning normally. [15][16][17] These defects have been demonstrated by ultrasonography 15 and by arthrography, 16'17 and confirm a loss of tissue fixation in a significant percentage of repairs.…”

mentioning

confidence: 83%

Tissue fixation security in transosseous rotator cuff repairs: A mechanical comparison of simple versus mattress sutures

Burkhart¹

1996

Journal of Shoulder and Elbow Surgery

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Arthrography of the shoulder after operative repair of the torn rotator cuff

Cited by 142 publications

References 7 publications

Bioabsorbable Tricalcium Phosphate Bone Cement Strengthens Fixation of Suture Anchors

Bioabsorbable Tricalcium Phosphate Bone Cement Strengthens Fixation of Suture Anchors

Operative release of the impingement syndrome

Tissue fixation security in transosseous rotator cuff repairs: A mechanical comparison of simple versus mattress sutures

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