Effect of Cyclic Loading on New Polyblend Suture Coupled with Different Anchors

Carli, Angelo De; Vadalà, Antonio; Monaco, Edoardo; Labianca, Luca; Zanzotto, Edoardo; Ferretti, Andrea

doi:10.1177/0363546504267348

Cited by 53 publications

(49 citation statements)

References 9 publications

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“…2 Fiberwire (Arthrex, Naples, FL, USA). These studies [1,19,20,53,55] unanimously agree that UHMWPE sutures have an Fig. 4 The arthroscopic rotator cuff repair.…”

Section: Suture Filament and Materialsmentioning

confidence: 84%

See 1 more Smart Citation

Rotator cuff tears: pathology and repair

Yadav

Nho

Romeo

et al. 2008

Knee Surg Sports Traumatol Arthrosc

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By virtue of its anatomy and function, the rotator cuff is vulnerable to considerable morbidity, often necessitating surgical intervention. The factors contributing to cuff disease can be divided into those extrinsic to the rotator cuff (most notably impingement) and those intrinsic to the cuff (age-related degeneration, hypovascularity and inflammation amongst others). In an era of emerging biologic interventions, our interventions are increasingly being modulated by our understanding of these core processes, many of which remain uncertain today. When we do intervene surgically, the techniques we employ are particularly challenging in the context of the tremendous pace of advancement. Several recent studies have shown that arthroscopic repair gives similar functional results to that of mini-open and open procedures, with all the benefits of minimally invasive surgery. However, the 'best' repair construct remains unknown, with wide variations in surgeon preference. Here we present a literature review encompassing recent developments in our understanding of basic science in rotator cuff disease as well as an up-to-date evidence-based comparison of different techniques available to the surgeon for cuff repair.

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“…2 Fiberwire (Arthrex, Naples, FL, USA). These studies [1,19,20,53,55] unanimously agree that UHMWPE sutures have an Fig. 4 The arthroscopic rotator cuff repair.…”

Section: Suture Filament and Materialsmentioning

confidence: 84%

“…Recommendations are for best biomechanical construct, not necessarily best clinical outcome. Data pooled from multiple sources [1,19,20,53,55,81,82] Knee Surg Sports Traumatol Arthrosc (2009) …”

Section: Suture Filament and Materialsmentioning

confidence: 99%

Rotator cuff tears: pathology and repair

Yadav

Nho

Romeo

et al. 2008

Knee Surg Sports Traumatol Arthrosc

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“…Other cyclic or time-dependent studies have been performed to gain insight over monotonic pullout tests, [11][12][13][14][15][16][17] with many focused on pullout strength after a limited number of cyclic loads or on tendon gap formation. Several authors have created unique experiments to assess long-term performance.…”

mentioning

confidence: 99%

Bearing area: A new indication for suture anchor pullout strength?

Yakacki

Griffis

Poukalova

et al. 2009

Journal Orthopaedic Research

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Studies performed to quantify the pullout strength of suture anchors have not adequately defined the basic device parameters that control monotonic pullout. The bearing area of a suture anchor can be used to understand and predict anchor pullout strength in a softbone model. First, conical-shaped test samples were varied in size and shape and tested for pullout in 5, 8, and 10 pcf sawbone models. Next, bearing area and pullout strength relationships developed from the test samples were validated against nine commercially available suture anchors, including the Mitek QuickAnchor and SpiraLok, Opus Magnum 2 , ArthroCare ParaSorb, and Arthrex BioCorkscrew. The samples showed a direct correlation between bearing area and pullout strength. Increased insertion depth was a secondary condition that also increased pullout strength. The pullout strength for the suture anchors followed the predicted trends of conical devices based on their individual bearing areas. For the 5 and 8 pcf models, only two and three devices, respectively, fell outside the predicted pullout strength range by more than a standard deviation. The use of a synthetic sawbone model was validated against the pullout strength of an Arthrex Corkscrew in five fresh-frozen cadaver humeral heads. The bearing area of a suture anchor can be used to predict the pullout strength independent of design in a soft-bone model. This work helps provide a foundation to understand the principles that affect the pullout strength of suture anchors. Keywords: suture anchors; pullout strength; soft bone; osteoporosis; bearing area Suture anchors are devices used to reattach a torn tendon to bone and are commonly used at active muscles sites. 1 These devices must possess good pullout strength so that rehabilitation can begin shortly after surgery. The pullout strengths of different types of anchors have been compared in a variety of bone models. [2][3][4][5][6][7][8] These studies have had significant clinical impact, but have not laid a foundation to understand basic design parameters controlling monotonic pullout. In some instances, studies were performed in healthy or hardbone models in which pullout is not the dominant mode of failure compared to suture breakage, device breakage, or tendon tearing. 9 Even when device pullout is the dominant failure mode, no fundamental understanding has emerged as to why some anchors perform better than others.In recent studies by Barber et al., 4,10 monotonic pull tests were performed on a range of suture anchors in a porcine model. Smaller sized suture anchors like the BioRaptor 2.9 and AxyaLoop/Parafix 3 mm devices mostly failed due to anchor pullout, while larger 5 to 6.5 mm devices like the SpiraLok, BioCorkscrews, and the AxyaLoop/ParaFix failed due to eyelet or suture breakage. Eyelet breakage was associated with polymer-based anchors; suture breakage was associated with titanium anchors. The study did not comprehensively assess pullout strength, as three modes of failure occurred due to the high bone density of the porc...

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“…Consequently, there were three implantation sites: an anterior, a medial and a posterior site. The implantation site of every anchor type was regularly alternated in order to minimize the influence of possible variations in bone quality at the various positions (De Carli et al, 2005;Schneeberger et al, 2002). The suture anchors were inserted according to the manufacturers' instructions at a 451 angle to the diaphysis of the humerus (Burkhart, 1995).…”

Section: Placing the Suture Anchorsmentioning

confidence: 99%

“…There are many different testing protocols described in the literature. Suture anchors have been tested in bovine Coons et al, 2006;Koganti et al, 2006;Lee et al, 2005;Petit et al, 2003); ovine (Cummins et al, 2005;Klinger et al, 2007); porcine (Barber et al, 1996) and human (De Carli et al, 2005;Pietschmann et al, 2009) bone. Petit et al (2003) stated as reason for using bovine shoulder that the average bone mineral density of immature bovine bone is similar to that of young human bone, citing the work of Gibson and Ashby showed that the Young's moduli plotted against bone density of bovine and human cancellous bone of the femur have an almost identical distribution.…”

Section: Introductionmentioning

confidence: 99%