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Knotless anchors with sutures external to the anchor body may be at risk for suture cutting through osteopenic bone

OBJECTIVES: This study evaluated the mechanical performance, under low-load cyclic loading, of two different knotless suture anchor designs: sutures completely internal to the anchor body (SpeedScrew) and sutures external to the anchor body and adjacent to bone (MultiFIX P). METHODS: Using standard...

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Autores principales: Ono, Y., Woodmass, J. M., Nelson, A. A., Boorman, R. S., Thornton, G. M., Lo, I. K. Y.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: British Editorial Society of Bone and Joint Surgery 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4957181/
https://www.ncbi.nlm.nih.gov/pubmed/27357383
http://dx.doi.org/10.1302/2046-3758.56.2000535
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author Ono, Y.
Woodmass, J. M.
Nelson, A. A.
Boorman, R. S.
Thornton, G. M.
Lo, I. K. Y.
author_facet Ono, Y.
Woodmass, J. M.
Nelson, A. A.
Boorman, R. S.
Thornton, G. M.
Lo, I. K. Y.
author_sort Ono, Y.
collection PubMed
description OBJECTIVES: This study evaluated the mechanical performance, under low-load cyclic loading, of two different knotless suture anchor designs: sutures completely internal to the anchor body (SpeedScrew) and sutures external to the anchor body and adjacent to bone (MultiFIX P). METHODS: Using standard suture loops pulled in-line with the rotator cuff (approximately 60°), anchors were tested in cadaveric bone and foam blocks representing normal to osteopenic bone. Mechanical testing included preloading to 10 N and cyclic loading for 500 cycles from 10 N to 60 N at 60 mm/min. The parameters evaluated were initial displacement, cyclic displacement and number of cycles and load at 3 mm displacement relative to preload. Video recording throughout testing documented the predominant source of suture displacement and the distance of ‘suture cutting through bone’. RESULTS: In cadaveric bone and foam blocks, MultiFIX P anchors had significantly greater initial displacement, and lower number of cycles and lower load at 3 mm displacement than SpeedScrew anchors. Video analysis revealed ‘suture cutting through bone’ as the predominant source of suture displacement in cadaveric bone (qualitative) and greater ‘suture cutting through bone’ comparing MultiFIX P with SpeedScrew anchors in foam blocks (quantitative). The greater suture displacement in MultiFIX P anchors was predominantly from suture cutting through bone, which was enhanced in an osteopenic bone model. CONCLUSIONS: Anchors with sutures external to the anchor body are at risk for suture cutting through bone since the suture eyelet is at the distal tip of the implant and the suture directly abrades against the bone edge during cyclic loading. Suture cutting through bone may be a significant source of fixation failure, particularly in osteopenic bone. Cite this article: Y. Ono, J. M. Woodmass, A. A. Nelson, R. S. Boorman, G. M. Thornton, I. K. Y. Lo. Knotless anchors with sutures external to the anchor body may be at risk for suture cutting through osteopenic bone. Bone Joint Res 2016;5:269–275. DOI: 10.1302/2046-3758.56.2000535.
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spelling pubmed-49571812016-08-03 Knotless anchors with sutures external to the anchor body may be at risk for suture cutting through osteopenic bone Ono, Y. Woodmass, J. M. Nelson, A. A. Boorman, R. S. Thornton, G. M. Lo, I. K. Y. Bone Joint Res Shoulder and Elbow OBJECTIVES: This study evaluated the mechanical performance, under low-load cyclic loading, of two different knotless suture anchor designs: sutures completely internal to the anchor body (SpeedScrew) and sutures external to the anchor body and adjacent to bone (MultiFIX P). METHODS: Using standard suture loops pulled in-line with the rotator cuff (approximately 60°), anchors were tested in cadaveric bone and foam blocks representing normal to osteopenic bone. Mechanical testing included preloading to 10 N and cyclic loading for 500 cycles from 10 N to 60 N at 60 mm/min. The parameters evaluated were initial displacement, cyclic displacement and number of cycles and load at 3 mm displacement relative to preload. Video recording throughout testing documented the predominant source of suture displacement and the distance of ‘suture cutting through bone’. RESULTS: In cadaveric bone and foam blocks, MultiFIX P anchors had significantly greater initial displacement, and lower number of cycles and lower load at 3 mm displacement than SpeedScrew anchors. Video analysis revealed ‘suture cutting through bone’ as the predominant source of suture displacement in cadaveric bone (qualitative) and greater ‘suture cutting through bone’ comparing MultiFIX P with SpeedScrew anchors in foam blocks (quantitative). The greater suture displacement in MultiFIX P anchors was predominantly from suture cutting through bone, which was enhanced in an osteopenic bone model. CONCLUSIONS: Anchors with sutures external to the anchor body are at risk for suture cutting through bone since the suture eyelet is at the distal tip of the implant and the suture directly abrades against the bone edge during cyclic loading. Suture cutting through bone may be a significant source of fixation failure, particularly in osteopenic bone. Cite this article: Y. Ono, J. M. Woodmass, A. A. Nelson, R. S. Boorman, G. M. Thornton, I. K. Y. Lo. Knotless anchors with sutures external to the anchor body may be at risk for suture cutting through osteopenic bone. Bone Joint Res 2016;5:269–275. DOI: 10.1302/2046-3758.56.2000535. British Editorial Society of Bone and Joint Surgery 2016-07-22 /pmc/articles/PMC4957181/ /pubmed/27357383 http://dx.doi.org/10.1302/2046-3758.56.2000535 Text en © 2016 Lo et al. This is an open-access article distributed under the terms of the Creative Commons Attributions licence (CC-BY-NC), which permits unrestricted use, distribution, and reproduction in any medium, but not for commercial gain, provided the original author and source are credited.
spellingShingle Shoulder and Elbow
Ono, Y.
Woodmass, J. M.
Nelson, A. A.
Boorman, R. S.
Thornton, G. M.
Lo, I. K. Y.
Knotless anchors with sutures external to the anchor body may be at risk for suture cutting through osteopenic bone
title Knotless anchors with sutures external to the anchor body may be at risk for suture cutting through osteopenic bone
title_full Knotless anchors with sutures external to the anchor body may be at risk for suture cutting through osteopenic bone
title_fullStr Knotless anchors with sutures external to the anchor body may be at risk for suture cutting through osteopenic bone
title_full_unstemmed Knotless anchors with sutures external to the anchor body may be at risk for suture cutting through osteopenic bone
title_short Knotless anchors with sutures external to the anchor body may be at risk for suture cutting through osteopenic bone
title_sort knotless anchors with sutures external to the anchor body may be at risk for suture cutting through osteopenic bone
topic Shoulder and Elbow
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4957181/
https://www.ncbi.nlm.nih.gov/pubmed/27357383
http://dx.doi.org/10.1302/2046-3758.56.2000535
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