Safety and Performance of Titanium Suture Anchors Used in Knee Ligament Repair Procedures

Abstract

Injuries to the knee ligaments can be particularly disabling in young patients, given the risk of long-term disability if adequate fixation is not achieved during initial repair. The TWINFIX™ titanium (Ti) suture anchor with ULTRABRAID™ Suture (Smith and Nephew, London, UK) was designed to secure tendon and ligament reconstructions with increased boney ingrowth at the anchor site with minimal invasive technique. This retrospective analysis looked at 33 patients (41 implants) operated with this device between 2015 and 2019 at a single institution. The average age of patients was 33.18 years (standard deviation [SD], 15.26), with an average body mass index of 24.88 (SD, 3.49). The indications were lateral extra-articular tenodesis during anterior cruciate ligament reconstruction, medial patellofemoral ligament reconstruction, quadriceps or patellar tendon repair and medial collateral ligament repair. After an average follow up of 24.3 + 6.53 months, there was no reports of clinical failure or radiographic evidence of implant failure or loosening. One patient experienced a complication unrelated to the study device, requiring manipulation under anesthesia with resolution of symptoms. This case series supports the safety and performance of this implants for the knee procedures in which its use is indicated. Additional follow-up will be required to determine whether these effects are sustained at medium- and long-term durations.

Comparison of Onlay Anchor Fixation Versus Transosseous Fixation for Lateral Extra-articular Tenodesis During Revision ACL Reconstruction

“…4 Recent studies have investigated the concept of onlay fixation using different metal or soft tissue anchors. 8,19,21 Clinical studies comparing onlay and intraosseus screw fixation are missing, but a recent animal study examined the biological properties of an onlay MCL fixation, which demonstrated nonsignificant differences when compared with the native MCL. 35 These results are in line with clinical data showing good to excellent results of ligament fixation using the anchor technique.…”

“…35 These results are in line with clinical data showing good to excellent results of ligament fixation using the anchor technique. 19,21 Another technical benefit of the aLET is the minimized risk of tunnel interference when performing a concomitant ACLR. Such tunnel conflicts have been reported in a substantial number of cadaveric studies.…”