Initial fixation and cyclic loading stability of knotless suture anchors for rotator cuff repair

Brown, Barrett S.; Cooper, Andrew; McIff, Terence E.; Key, Vincent; Toby, E. Bruce

doi:10.1016/j.jse.2007.05.016

Cited by 25 publications

(19 citation statements)

References 10 publications

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“…Recently, knotless repairs have been introduced as a refined technique [31, 32]. The advantages of knotless technique included reducing surgery time, eliminating medial and lateral knot impingement.…”

Section: Discussionmentioning

confidence: 99%

Biomechanical Comparison of Modified Suture Bridge Using Rip-Stop versus Traditional Suture Bridge for Rotator Cuff Repair

Zhang

et al. 2016

BioMed Research International

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Purpose. To compare the biomechanical properties of 3 suture-bridge techniques for rotator cuff repair. Methods. Twelve pair-matched fresh-frozen shoulder specimens were randomized to 3 groups of different repair types: the medially Knotted Suture Bridge (KSB), the medially Untied Suture Bridge (USB), and the Modified Suture Bridge (MSB). Cyclic loading and load-to-failure test were performed. Parameters of elongation, stiffness, load at failure, and mode of failure were recorded. Results. The MSB technique had the significantly greatest load to failure (515.6 ± 78.0 N, P = 0.04 for KSB group; P < 0.001 for USB group), stiffness (58.0 ± 10.7 N/mm, P = 0.005 for KSB group; P < 0.001 for USB group), and lowest elongation (1.49 ± 0.39 mm, P = 0.009 for KSB group; P = 0.001 for USB group) among 3 groups. The KSB repair had significantly higher ultimate load (443.5 ± 65.0 N) than USB repair (363.5 ± 52.3 N, P = 0.024). However, there was no statistical difference in stiffness and elongation between KSB and USB technique (P = 0.396 for stiffness and P = 0.242 for elongation, resp.). The failure mode for all specimens was suture pulling through the cuff tendon. Conclusions. Our modified suture bridge technique (MSB) may provide enhanced biomechanical properties when compared with medially knotted or knotless repair. Clinical Relevance. Our modified technique may represent a promising alternative in arthroscopic rotator cuff repair.

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Section: Discussionmentioning

confidence: 99%

Biomechanical Comparison of Modified Suture Bridge Using Rip-Stop versus Traditional Suture Bridge for Rotator Cuff Repair

Zhang

et al. 2016

BioMed Research International

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“…11,20 Estudos mecânicos em cadáveres e estudos em modelo animal demonstraram relação entre a perda da densidade mineral óssea e as falhas das suturas tendinosas. 21,22 Brown et al 21 demonstraram que a baixa densidade mineral óssea no tubérculo maior dos cadáveres operados foi um fator significante para a reabertura após a sutura artroscópica do MR. Cadet et al, 22 ao melhorar a densidade óssea na região de inserção do MR de ratos que receberam bifosfonados, demonstraram o prolongamento do tempo de falha por estresse da sutura tendinosa.…”

Section: Discussionunclassified

“…[13][14][15][16][17] Alguns dados a respeito da perda de massa óssea no tubér-culo maior induzida pela lesão do MR estão publicados na literatura. [18][19][20] Esses dados e alguns estudos mecânicos sugerem um possível efeito deletério da osteopenia na cicatrização pós-operatória do MR. 11,21,22 Não encontramos dados de aná-lise da relação entre a perda óssea inerente ao envelhecimento com o resultado da sutura artroscópica do MR.…”

Section: Introductionunclassified

Análise comparativa da sutura artroscópica de lesões grandes e extensas do manguito rotador com relação ao grau de osteopenia

Almeida¹,

Atti

Agostini³

et al. 2015

Revista Brasileira de Ortopedia

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“…9 , 10 When compared with conventional anchors, knotless suture anchors exhibited similar or greater loads in failure tests but similar or greater displacements in cyclic tests. 5 , 8 , 11 , 12 Conventional and knotless suture anchors have also demonstrated equivalent clinical outcomes during Bankart repairs. 13 …”

Section: Introductionmentioning

confidence: 99%

Suture locking of isolated internal locking knotless suture anchors is not affected by bone quality

Woodmass

Matthewson

et al. 2015

OAJSM

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PurposeThe purpose of this study was to evaluate the mechanical performance of different suture locking mechanisms including: i) interference fit between the anchor and the bone (eg, 4.5 mm PushLock, 5.5 mm SwiveLock), ii) internal locking mechanism within the anchor itself (eg, 5.5 mm SpeedScrew), or iii) a combination of interference fit and internal locking (eg, 4.5 mm MultiFIX P, 5.5 mm MultiFIX S).MethodsAnchors were tested in foam blocks representing normal (20/8 foam) or osteopenic (8/8 foam) bone, using standard suture loops pulled in-line with the anchor to isolate suture locking. Mechanical testing included cyclic testing for 500 cycles from 10 N to 60 N at 60 mm/min, followed by failure testing at 60 mm/min. Displacement after 500 cycles at 60 N, number of cycles at 3 mm displacement, load at 3 mm displacement, and maximum load were evaluated.ResultsComparing 8/8 foam to 20/8 foam, load at 3 mm displacement and maximum load were significantly decreased (P<0.05) with decreased bone quality for anchors that, even in part, relied on an interference fit suture locking mechanism (ie, 4.5 mm PushLock, 5.5 mm SwiveLock, 4.5 mm MultiFIX P, 5.5 mm MultiFIX S). Bone quality did not affect the mechanical performance of 5.5 mm SpeedScrew anchors which have an isolated internal locking mechanism.ConclusionThe mechanical performance of anchors that relied, even in part, on interference fit were affected by bone quality. Isolated internal locking knotless suture anchors functioned independently of bone quality. Anchors with a combined type (interference fit and internal locking) suture locking mechanism demonstrated similar mechanical performance to isolated internal locking anchors in osteopenic foam comparing similar sized anchors.Clinical relevanceIn osteopenic bone, knotless suture anchors that have an internal locking mechanism (isolated or combined type) may be advantageous for secure tendon fixation to bone.

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Initial fixation and cyclic loading stability of knotless suture anchors for rotator cuff repair

Cited by 25 publications

References 10 publications

Biomechanical Comparison of Modified Suture Bridge Using Rip-Stop versus Traditional Suture Bridge for Rotator Cuff Repair

Biomechanical Comparison of Modified Suture Bridge Using Rip-Stop versus Traditional Suture Bridge for Rotator Cuff Repair

Análise comparativa da sutura artroscópica de lesões grandes e extensas do manguito rotador com relação ao grau de osteopenia

Suture locking of isolated internal locking knotless suture anchors is not affected by bone quality

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