Three Medial All Suture Anchors Improves Contact Force Compared to Two Hard Body Anchors in a Biomechanical Two-Tendon Rotator Cuff Tear Model

Hoffman, Tammy R.; Lamplot, Joseph D.; McClish, Sarah J.; Payne, Cassie; Denard, Patrick J.

doi:10.1016/j.asmr.2022.05.012

Cited by 3 publications

(6 citation statements)

References 36 publications

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“…Importance of this concept has been described in several Achilles bridge repairs, 2,4,23 as well as in the rotator cuff repairs to facilitate biologic incorporation and accelerated healing. 11 Beitzel et al 2 found that with a double-row Achilles anchor configuration (comparable by anchor size to the SDR group), the mean ultimate load was 433.9 ± 84.3 N. This is within 10% of our SDR mean ultimate load.…”

Section: Discussionsupporting

confidence: 62%

“…More recently, all-suture anchors have increased in popularity in lieu of a hard-body anchored construct because of their pullout strength, ease of revision, and lessened volume of drilling required. 11 All-suture anchors have also been correlated with decreased bone damage in the case of pullout. 16 Because of this observation in the literature, all-suture anchors were used for the proximal anchors of the RS-DR, conjoined by a rip-stop suture.…”

Section: Discussionmentioning

confidence: 99%

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Double-Row Achilles Insertional Repair With Rip-Stop Increases Construct Strength Compared to Traditional Techniques: A Biomechanical Study

Vora,

Ingwer,

Withrow

et al. 2024

Foot Ankle Int.

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Background: Although double-row suture-anchored (DRSA) techniques for Achilles insertional tendinosis has proven successful, a reoccurring failure mode not yet addressed is suture tearing through the tendon. This study aims to address suture tearing by incorporating a rip-stop element. Authors hypothesized that the Rip-Stop group would demonstrate increased strength compared with more traditional techniques. Methods: 12 paired cadaveric feet were used in this study (n = 24). One sample from each pair was assigned to receive the standard double-row (SDR) Achilles repair with 4.75-mm knotless anchors (n = 12). The control’s matched sides were divided between 2 DRSA bridge groups: modified double-row (MDR) bridge with 3.9-mm anchors or rip-stop double-row (RS-DR) bridge repair with soft proximal anchors and 3.9-mm anchored distal row. In neutral position, specimens underwent 1000 cycles (20-100 N) followed by load to failure. Displacements, stiffness, ultimate load, and failure mode were recorded. Results: RS-DR had the lowest initial displacement values followed by SDR and MDR (1.3 ± 0.4, 2.7 ± 1.4, and 3.2 ± 1.3 mm, respectively). Significance was detected when comparing initial displacement of RS-DR to MDR ( P = .038). Cyclic displacement was lowest for RS-DR, followed by MDR and SDR (1.6 ± 0.9, 2.2 ± 1.1, and 4.5 ± 3.2 mm, respectively). Cyclic stiffness was similar for RS-DR and MDR (89.1 ± 24.6 and 81.9 ± 5.6 N/mm, respectively). RS-DR ultimate load (1116.8 ± 405.7 N) was statistically greater than SDR (465.6 ± 352.7, P = .003). Conclusion: RS-DR–repaired specimens demonstrated a decrease in displacement values and increased ultimate load and stiffness when compared to other groups. Results of this cadaveric model suggest that the addition of a rip-stop to DRSA Achilles repair is more impactful than anchor size. Limitations include that this was a time-zero biomechanical study, which cannot simulate the performance of the repairs during postoperative healing and recovery. Clinical Relevance: A rip-stop technique for Achilles repair effectively improves dynamic mechanical characteristics and may mitigate suture tearing through tendon in a patient cohort.

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Section: Discussionsupporting

confidence: 62%

Section: Discussionmentioning

confidence: 99%

Double-Row Achilles Insertional Repair With Rip-Stop Increases Construct Strength Compared to Traditional Techniques: A Biomechanical Study

Vora,

Ingwer,

Withrow

et al. 2024

Foot Ankle Int.

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“…This type of plow was used in Europe and from there to other parts of the world. These types of plows bury 90 to 95% of crop residues in each series of operations and only 5 to 10% of the residues and topsoil are not removed [17].…”

Section: Related Workmentioning

confidence: 99%

Using Different Angles of Rotating Blades Using the Finite Element Method

Ali Hassan,

Soheili Mehdizadeh

2024

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One of the most important operations in agriculture is tillage, which has a great contribution to increasing crop yield and aeration of the soil and, ultimately, root development. Among the important tools for tillage are rotary rotators that are exposed to high and variable dynamic loads, so they are designed to have both the greatest contribution to soil agitation and high strength; It is necessary. Therefore, in this research, an L-shaped blade sample was designed for a rotator using a Biomimetic method. Due to the extensive research that has been done in the world in the field of manufacturing different types of rotators with a rotating agitator mechanism, therefore, it is necessary to study and optimize the rotator blades according to Iranian conditions. In this study, the studied variables include dependent and independent variables. Dependent variables include von Mises stress and arm displacement, and independent variables include the dimensions and geometric parameters of the Shape of the Rotator Blades. The idea for the blade design was inspired by the paw of a mole rat. Six blades were designed by simple method and biomimetic method and then by finite element method. Effects of blade angle change and design method on stress distribution, maximum displacement, maximum energy absorbed in the blade, reliability and under 400 N checked out. The results showed that in all designed models, the values of stress, displacement and energy absorbed were lower in the biomimetic design mode. As the blade angle increased, the values of the above parameters also decreased. Finally, the best model for having the least von Mises stress and the highest reliability was the blade with a Biomimetic design and a 20-degree angle.

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“…Hoffman et al performed knotless double-row repairs in a 2-tendon rotator cuff repair model using 2 repair techniques, which differed in medial-row fixation 11 . The soft anchor group used 3 medial 2.6-mm soft anchors while the hard body anchor group used 2 medial 4.75-mm anchors.…”

Section: Biomechanical Testing For Double-row Rotator Cuff Repairmentioning

confidence: 99%

“…In the setting of a large or massive tear, 3 soft anchors can be placed medially with approximately the same footprint violation of 2 hard body anchors. These additional sutures per unit area can improve the points of fixation and subsequent contact force if applied as a double-row repair 11 .…”

mentioning

confidence: 99%

Soft Anchors for Rotator Cuff Repair

et al. 2023

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All-suture anchors or so-called “soft” anchors, initially adapted for labral repairs, have increased in popularity for use in rotator cuff repair because of their smaller size, decreased occupation of the footprint, improved points of fixation, ease of use, and ease of revision.In limited series, soft anchors have demonstrated equivalent biomechanical and clinical performance compared with hard body anchors for rotator cuff repair.Perianchor cyst formation can occur with both hard body and soft anchors.Biomechanical and clinical data support aiming for vertical angles of insertion for soft anchors.

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Three Medial All Suture Anchors Improves Contact Force Compared to Two Hard Body Anchors in a Biomechanical Two-Tendon Rotator Cuff Tear Model

Cited by 3 publications

References 36 publications

Double-Row Achilles Insertional Repair With Rip-Stop Increases Construct Strength Compared to Traditional Techniques: A Biomechanical Study

Double-Row Achilles Insertional Repair With Rip-Stop Increases Construct Strength Compared to Traditional Techniques: A Biomechanical Study

Using Different Angles of Rotating Blades Using the Finite Element Method

Soft Anchors for Rotator Cuff Repair

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