Biomechanical testing of trans-humeral all-suture anchors for rotator cuff repair

Abstract

Background: Rotator cuff tears are one of the most common causes of shoulder pain. All-suture anchors are increasingly being used in the arthroscopic repair of rotator cuff tears. The purpose of this experimental study is to evaluate the biomechanical properties of all-suture anchors at different insertion sites in the proximal humerus relevant to rotator cuff repairs and the remplissage procedure. Methods: Sixteen cadaveric shoulders were used for the study. Four all-suture anchors were inserted in each proximal humerus at common anchor insertion sites on the rotator cuff footprint and a simulated Hill-Sachs defect. Cyclic loading and load-to-failure tests were undertaken. The number of cycles, load to failure and nature of failure were recorded. Results: The all-suture anchors placed in the cuff footprint using a transosseous technique displayed superior biomechanical properties. Sutures sited in this way demonstrated a maximum tensile load to failure of 542 N as well as a highest mean load to failure and the maximum number of cycles before anchor failure. In descending order, all-suture anchors placed in the lateral footprint were significantly superior to those located in the medial row and in a simulated Hill-Sachs defect. Discussion: Anchors placed in the rotator cuff footprint exceeded the physiological isometric abduction forces for the supraspinatus and infraspinatus. Data obtained from our study suggest that all-suture anchors are strong enough to be used for the repair of rotator cuff tears.

Fast Arthroscopic Biceps Tenodesis Without Penetrating Grasper

“…In conclusion, considering the benefits of arthroscopic tenodesis and the good biomechanical results with all suture anchor fixation, 14 we believe that our technique is a reproducible, simple, fast, and with many technical advantages ( Table 1 ). In addition, it is an alternative to be used in associated pathologies of the shoulder such as rotator cuff injuries.…”

All-Suture Anchors in Orthopaedic Surgery: Design, Rationale, Biomechanical Data, and Clinical Outcomes

“…14,16-18 However, some notable exceptions can be found in the literature. Nagra et al 19 found the loads to failure of 4 ASAs, including 3 of the aforementioned anchors, to all be less than 150 N. In a study by Aramberri-Gutiérrez et al 20 on the 2.3-mm Iconix, loads were similarly low, between 150 and 225 N. Many studies directly compared ASAs with non-ASA anchors. Compared with metallic and bioresorbable anchors, ASAs tend to have higher loads to failure, though not always significantly so.…”

“…12 In biomechanical studies, displacement after cyclic loading is used a surrogate measure. A handful of studies report displacements less than 2.5 mm for the 2.3-mm Iconix, 14,18,20 2.8-mm Y-Knot, 14,17,20 and 2.8-mm Q-Fix, 14 although some studies report displacements over 5 mm and as high as 15 mm. 16,19,21 However, in these studies with higher displacements, the displacements for ASAs are not significantly different than those of solid anchor controls.…”