Bony Ingrowth of Coil-Type Open-Architecture Anchors Compared With Screw-Type PEEK Anchors for the Medial Row in Rotator Cuff Repair: A Randomized Controlled Trial

Chahla, Jorge; Liu, Joseph N.; Manderle, Brandon J.; Beletsky, Alexander; Cabarcas, Brandon C.; Gowd, Anirudh K.; Inoue, Nozomu; Chubinskaya, Susan; Trenhaile, Scott W.; Forsythe, Brian; Cole, Brian J.

doi:10.1016/j.arthro.2019.11.119

Cited by 14 publications

(26 citation statements)

References 29 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: 97%

“…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%

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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: 97%

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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“…Increasing surface area and incorporation of porous structures into an iron-based biodegradable material can accelerate its degradation rate [ 5 , 20 , 21 , 22 , 23 ]. Our control group suture anchors were famous for its open architecture in appearance that had the higher surface area [ 24 , 25 ]. In this study, we innovated bioabsorbable iron-based porous suture anchors (hereafter referred to as iron SAs) by using control group suture anchor as reference template.…”

Section: Introductionmentioning

confidence: 99%

Biocompatibility and Biological Performance Evaluation of Additive-Manufactured Bioabsorbable Iron-Based Porous Suture Anchor in a Rabbit Model

Tai

Liaw

et al. 2021

IJMS

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This study evaluated the biocompatibility and biological performance of novel additive-manufactured bioabsorbable iron-based porous suture anchors (iron_SAs). Two types of bioabsorbable iron_SAs, with double- and triple-helical structures (iron_SA_2_helix and iron_SA_3_helix, respectively), were compared with the synthetic polymer-based bioabsorbable suture anchor (polymer_SAs). An in vitro mechanical test, MTT assay, and scanning electron microscope (SEM) analysis were performed. An in vivo animal study was also performed. The three types of suture anchors were randomly implanted in the outer cortex of the lateral femoral condyle. The ultimate in vitro pullout strength of the iron_SA_3_helix group was significantly higher than the iron_SA_2_helix and polymer_SA groups. The MTT assay findings demonstrated no significant cytotoxicity, and the SEM analysis showed cells attachment on implant surface. The ultimate failure load of the iron_SA_3_helix group was significantly higher than that of the polymer_SA group. The micro-CT analysis indicated the iron_SA_3_helix group showed a higher bone volume fraction (BV/TV) after surgery. Moreover, both iron SAs underwent degradation with time. Iron_SAs with triple-helical threads and a porous structure demonstrated better mechanical strength and high biocompatibility after short-term implantation. The combined advantages of the mechanical superiority of the iron metal and the possibility of absorption after implantation make the iron_SA a suitable candidate for further development.

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“…The HU value at each point e was calculated by a trilinear interpolation algorithm using HU values at 8 adjacent pixels in 2 adjacent axial CT slices (Fig. 1 C) 29 . A total of 90,000 HU datapoints were obtained within the cylindrical range of interest (ROI) shown in Fig.…”

Section: Methodsmentioning

confidence: 99%

Three-dimensional distribution of CT attenuation in the lumbar spine pedicle wall

Irie

Orías

Segami

et al. 2021

Sci Rep

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This study investigated in vivo the three-dimensional distribution of CT attenuation in the lumbar spine pedicle wall measured in Hounsfield Unit (HU). Seventy-five volunteers underwent clinical lumbar spine CT scans. Data was analyzed with custom-written software to determine the regional variation in pedicle wall attenuation values. A cylindrical coordinate system oriented along the pedicle’s long axis was used to calculate the pedicular wall attenuation distribution three-dimensionally and the highest attenuation value was identified. The pedicular cross-section was divided into four quadrants: lateral, medial, cranial, and caudal. The mean HU value for each quadrant was calculated for all lumbar spine levels (L1–5). The pedicle wall attenuation was analyzed by gender, age, spinal levels and anatomical quadrant. The mean HU values of the pedicle wall at L1 and L5 were significantly lower than the values between L2–4 in both genders and in both age groups. Furthermore, the medial quadrant showed higher HU values than the lateral quadrant at all levels and the caudal quadrant showed higher HU values at L1–3 and lower HU values at L4–5 than the cranial quadrant. These findings may explain why there is a higher incidence of pedicle screw breach in the pedicle lateral wall.

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Bony Ingrowth of Coil-Type Open-Architecture Anchors Compared With Screw-Type PEEK Anchors for the Medial Row in Rotator Cuff Repair: A Randomized Controlled Trial

Cited by 14 publications

References 29 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

Biocompatibility and Biological Performance Evaluation of Additive-Manufactured Bioabsorbable Iron-Based Porous Suture Anchor in a Rabbit Model

Three-dimensional distribution of CT attenuation in the lumbar spine pedicle wall

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