Early anchor displacement after arthroscopic rotator cuff repair

Skaliczki, Gábor; Paladini, Paolo; Merolla, Giovanni; Campi, Fabrizio; Porcellini, Giuseppe

doi:10.1007/s00264-015-2690-1

Cited by 18 publications

(14 citation statements)

References 25 publications

(39 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In the context of traditional anchors, early post-operative anchor movement is a relatively rare complication, reported as 0.1% in one study. 23 As there has been greater suggested displacement in all-suture anchors in this and other studies, there is cause to consider large-scale follow-up studies of patients with all-suture anchors, especially in the immediate post-operative period.…”

Section: Discussionmentioning

confidence: 75%

Mechanical properties of all-suture anchors for rotator cuff repair

Nagra

Zargar

Smith

et al. 2017

Bone & Joint Research

View full text Add to dashboard Cite

ObjectivesAll-suture anchors are increasingly used in rotator cuff repair procedures. Potential benefits include decreased bone damage. However, there is limited published evidence for the relative strength of fixation for all-suture anchors compared with traditional anchors.Materials and MethodsA total of four commercially available all-suture anchors, the ‘Y-Knot’ (ConMed), Q-FIX (Smith & Nephew), ICONIX (Stryker) and JuggerKnot (Zimmer Biomet) and a traditional anchor control TWINFIX Ultra PK Suture Anchor (Smith & Nephew) were tested in cadaveric human humeral head rotator cuff repair models (n = 24). This construct underwent cyclic loading applied by a mechanical testing rig (Zwick/Roell). Ultimate load to failure, gap formation at 50, 100, 150 and 200 cycles, and failure mechanism were recorded. Significance was set at p < 0.05.ResultsOverall, mean maximum tensile strength values were significantly higher for the traditional anchor (181.0 N, standard error (se) 17.6) compared with the all-suture anchors (mean 133.1 N se 16.7) (p = 0.04). The JuggerKnot anchor had greatest displacement at 50, 100 and 150 cycles, and at failure, reaching statistical significance over the control at 100 and 150 cycles (22.6 mm se 2.5 versus 12.5 mm se 0.3; and 29.6 mm se 4.8 versus 17.0 mm se 0.7). Every all-suture anchor tested showed substantial (> 5 mm) displacement between 50 and 100 cycles (6.2 to 14.3).All-suture anchors predominantly failed due to anchor pull-out (95% versus 25% of traditional anchors), whereas a higher proportion of traditional anchors failed secondary to suture breakage.ConclusionWe demonstrate decreased failure load, increased total displacement, and variable failure mechanisms in all-suture anchors, compared with traditional anchors designed for rotator cuff repair. These findings will aid the surgeon’s choice of implant, in the context of the clinical scenario.Cite this article: N. S. Nagra, N. Zargar, R. D. J. Smith, A. J. Carr. Mechanical properties of all-suture anchors for rotator cuff repair. Bone Joint Res 2017;6:82–89. DOI: 10.1302/2046-3758.62.BJR-2016-0225.R1

show abstract

Section: Discussionmentioning

confidence: 75%

Mechanical properties of all-suture anchors for rotator cuff repair

Nagra

Zargar

Smith

et al. 2017

Bone & Joint Research

View full text Add to dashboard Cite

show abstract

“…Rotator cuff repair integrity was assessed by MRI at 12 months postoperatively and graded using the Sugaya classification. 23 Scans showed complete healing in 10 of the 15 cases. Overall, the repairs were assessed as Sugaya type I, 10; type II, 1; type III, 2; type IV, 1; and type V, 1.…”

Section: Resultsmentioning

confidence: 92%

“…Although such a displacement has not been commonly reported, various techniques have been described to address this technical issue. 2,23 Simulating the exact mini open technique using transosseous sutures has been described with satisfactory outcomes 17 but still requires intracorporeal knot tying, 1,15 and the simple stitch configuration has been associated with increased cutout from the bone tunnels. 6 In an effort to create an approach that would facilitate a true transosseous repair using an arthroscopic technique, and with improved hold in osteoporotic bone, a suturestabilizing anchor has been developed, named ATOK (Arthroscopic Trans-Osseous Knotless; Signature Orthopaedics, Sydney, Australia) ( Fig.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Arthroscopic rotator cuff repair using a transosseous knotless anchor (ATOK)

Sandow

Schutz

2020

Journal of Shoulder and Elbow Surgery

View full text Add to dashboard Cite

Background: This article reviews the clinical and radiographic outcomes in a noninferiority trial use of a transosseous knotless anchor to perform arthroscopic rotator cuff repairs in a patient cohort that have an increased incidence of osteoporosis. Methods: Patients aged over 60 with a documented rotator cuff tear and who failed a rehab program underwent repair using an arthroscopic transosseous knotless (ATOK) anchor. Patients were prospectively reviewed using shoulder functional assessments (age-adjusted Constant score, Oxford Shoulder Score, American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form [ASES], visual analog scale [VAS] pain scores), and underwent preoperative as well as 1-, 3-, and 12-month postoperative magnetic resonance imaging. Results: 15 patients had undergone rotator cuff repair using the ATOK and were followed for a minimum of 24 months (range 24-30 months). From preoperative to 24 months post repair, median scores improved for ASES (61-89), Oxford (26-44), Constant (62-91), and VAS Pain (5-0.5). Four patients developed a partial retear of their repair, but only 1 patient sustained a complete retear: Sugaya type I, 10; type II, 1; type III, 2; type IV, 1; and type V, 1. No anchors were displaced, and there were no osteolysis, neurologic, or technique-related complications. Conclusions: Arthroscopic rotator cuff repairs using a transosseous knotless technique has achieved a satisfactory outcome in this group of patients, who typically have poor bone quality, increasing the risk of antegrade anchor pullout. This approach would appear to combine the potential biomechanical and biological advantages of a transosseous repair technique, with the benefits of the lower morbidity arthroscopic surgical approach. Level of evidence: Level IV; Case Series; Treatment Study Ó 2019 The Authors. This is an open access article under the CC BY-NC-ND license (http:// creativecommons.org/licenses/by-nc-nd/4.0/).

show abstract

“…Rotator manşet cerrahisinde dikiş çapa-sı yerleşimi sonrası geri gelme değişik çalışmalarda %0,1 ile %3,1 arasında bildirilmiştir (50)(51)(52) . Osteoporoz, retrakte manşet yırtığı ve birden fazla güçlendirilmiş sütürün tek implanta yüklenmesi geri gelme riskini artıran faktörlerdir (50,53) . Yapılan bir çalışmada, dikiş çapalarının humeral baş eklem yüzeyine 90 derece açı ile uygulamasının biomekanik olarak en stabil uygulama olduğu bildirilmiştir (54) .…”

Section: İmplant Ilişkili Komplikasyonlarunclassified

Review: Complications of Rotator Cuff Surgery

Çelik¹,

Seçkin²,

Akman³

2017

Okmeydani Medical Journal

View full text Add to dashboard Cite

ÖZ GİRİŞRotator manşet yırtıkları ve subakromial bölge sorunları omuz ağrısının yaygın nedenlerindendir. Rotator manşet yırtığı, 50-59 yaş aralığında %13 oranda gö-rülürken, bu oran 80 yaş üzerinde %51'e kadar yük-selmektedir (1) .Önceki yıllarda açık girişim ile yapılan rotator manşet onarımı yıllar içinde artroskopik tekniklerin geliş-mesi ile önce artroskopik yardımlı mini-açık tekniğe ardından yalnızca artroskopik tekniğe doğru kaymış-tır. Tedavide öncelikli hedef fonksiyonel bir rotator kablo yaratmak olan bu patolojide uygulanan tekniklerin birtakım komplikasyonları olduğu bilinmelidir. Rotator manşet cerrahisi sonrası kısa ve uzun dönem takip sırasında omuz ekleminde ağrı oluşması önem-senmeli, ağrı nedenleri cerrah tarafından sistematik olarak değerlendirilmelidir (Tablo 1).Rotator manşet cerrahisi komplikasyonları, ameliyat öncesi hastaya ve patolojiye ait sorunlara bağlı komplikasyonlar, ameliyat sırasındaki tekniğe ve cerraha ait sorunlar ile cerrahi sonrası özellikle fizik tedaviye ait sorunlar olarak kabaca üç gruba ayrılarak incelenebilir. Bu komplikasyonlar onarılan manşetin yeniden yırtılması, akromion kırıkları, yineleyen subakromial enflamasyon, heterotopik ossifikasyon, omuz sertliği, enfeksiyon, sinir yaralanmaları, deltoid kasın akromiona dikildiği yerden ayrılması ve omuzun öne çıkığı olarak ortaya çıkabilir (Tablo 2) (3) .Bu bölümde artroskopik omuz cerrahisine bağlı komplikasyonlar ve rotator manşet cerrahisine bağlı komplikasyonlar iki ayrı bölümde değerlendirilmiştir.

show abstract

Early anchor displacement after arthroscopic rotator cuff repair

Abstract: Based on our study, anchor pullout occurring immediately after surgery is a relatively rare complication. Instead of timing the radiologic examination directly after the procedure, assessment of the anchors' position four to six weeks after surgery should be considered.

Cited by 18 publications

References 25 publications

Mechanical properties of all-suture anchors for rotator cuff repair

Mechanical properties of all-suture anchors for rotator cuff repair

Arthroscopic rotator cuff repair using a transosseous knotless anchor (ATOK)

Review: Complications of Rotator Cuff Surgery

Contact Info

Product

Resources

About