المؤلفون: Joshua B. Baldino, Matthew Murphy, Sebastian Siebenlist, Elifho Obopilwe, Julian Mehl, Augustus D. Mazzocca, Alexander Otto, Andreas B. Imhoff, Lukas N. Muench, Mark P. Cote

المصدر: JSES International, Vol 4, Iss 4, Pp 833-837 (2020)
JSES International

مصطلحات موضوعية: Shoulder, lcsh:Diseases of the musculoskeletal system, Shoulders, long head of the biceps tendon, All-suture anchor, Biceps, Rotator Cuff, lcsh:Orthopedic surgery, Medicine, Orthopedics and Sports Medicine, Displacement (orthopedic surgery), ddc:610, Suture anchors, Orthodontics, Bone mineral, subpectoral tenodesis, business.industry, Biomechanics, LHB tenodesis, ddc, Tendon, unicortical biceps button, lcsh:RD701-811, medicine.anatomical_structure, Surgery, LHB, lcsh:RC925-935, business, Cadaveric spasm

الوصف: Hypothesis The purpose of this study was to biomechanically evaluate onlay subpectoral long head of the biceps (LHB) tenodesis with all-suture anchors and unicortical buttons in cadaveric specimens. Methods After evaluation of bone mineral density, 18 fresh-frozen, unpaired human cadaveric shoulders were randomly assigned to 2 groups: One group received an onlay subpectoral LHB tenodesis with 1 all-suture anchor, whereas the other group received a tenodesis with 1 unicortical button. The specimens were mounted in a servo-hydraulic material testing system. Tendons were initially loaded from 5 N to 100 N for 5000 cycles at 1 Hz. Displacement of the repair constructs was observed with optical tracking. After cyclic loading, each specimen was loaded to failure at a rate of 1 mm/s. Results The mean displacement after cyclic loading was 6.77 ± 3.15 mm in the all-suture anchor group and 8.41 ± 3.17 mm in the unicortical button group (P = not significant). The mean load to failure was 278.05 ± 38.77 N for all-suture anchor repairs and 291.36 ± 49.69 N for unicortical button repairs (P = not significant). The most common mode of failure in both groups was LHB tendon tearing. There were no significant differences between the 2 groups regarding specimen age (58.33 ± 4.37 years vs. 58.78 ± 5.33 years) and bone mineral density (0.50 ± 0.17 g/cm2 vs. 0.44 ± 0.19 g/cm2). Conclusion All-suture anchors and unicortical buttons are biomechanically equivalent in displacement and load-to-failure testing for LHB tenodesis. All-suture anchors can be considered a validated alternative for onlay subpectoral LHB tenodesis.

وصف الملف: application/pdf

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::c350d151dce69d5b1d372a872fa510bcTest
http://www.sciencedirect.com/science/article/pii/S2666638320301353Test

المؤلفون: Mark P. Cote, Joshua B. Baldino, Alexander Otto, Katherine Coyner, Knut Beitzel, Augustus D. Mazzocca, Alyssa M. DiCosmo, Andreas B. Imhoff, Julian Mehl, Elifho Obopilwe

المصدر: Orthopaedic Journal of Sports Medicine

مصطلحات موضوعية: Orthodontics, hip, business.industry, proximal hamstring avulsion, Biomechanics, Article, biomechanics, Tendon, ddc, titanium suture anchor, all-suture anchor, medicine.anatomical_structure, medicine, Orthopedics and Sports Medicine, ddc:610, business, Hamstring, Suture anchors, proximal hamstring repair

الوصف: Background: Proximal hamstring avulsions are severe tendon injuries and are commonly sports-related. Open and endoscopic techniques as well as different anchor configurations have already been described for proximal hamstring repair. Novel all-suture anchors have been developed to provide decreased bone loss during placement and reduced occupied bone volume when compared with titanium suture anchors. Hypothesis: Complete proximal hamstring avulsions repaired with all-suture anchors will demonstrate equal load to failure and comparable displacement under cyclic loading when compared with titanium suture anchors. Study Design: Controlled laboratory study. Methods: Complete proximal hamstring avulsions were created in 18 paired cadaveric specimens (mean ± SD age, 63.0 ± 10.4 years). Either all-suture anchors or titanium suture anchors were used for repair. Cyclic loading from 10 to 125 N at 1 Hz was performed for 1500 cycles with a material testing machine. Displacement was assessed along anterior and posterior aspects of the tendon repair with optical tracking. Specimens were loaded to failure at a rate of 120 mm/min. Displacement, load to failure, and repair construct stiffness were compared between matched pairs with the Wilcoxon signed-rank test. Correlations were determined by Spearman rho analysis. Results: The all-suture anchors showed significantly higher load-to-failure values when compared with the titanium anchor repairs (799.64 ± 257.1 vs 573.27 ± 89.9 N; P = .008). There was no significant difference in displacement between all-suture anchors and titanium suture anchors at the anterior aspect (6.60 ± 2.2 vs 5.49 ± 1.1 mm; P = .26) or posterior aspect (5.87 ± 2.08 vs 5.23 ± 1.37 mm; P = .678) of the repaired hamstring tendons. Conclusion: All-suture anchors demonstrated similar displacement and superior load to failure when compared with titanium suture anchors. Clinical Relevance: The results of this study suggest that all-suture anchors are an equivalent alternative to titanium suture anchors for proximal hamstring avulsion repair.

وصف الملف: application/pdf

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::d789371c4375feceb5edba40957e5b4aTest
https://opus.bibliothek.uni-augsburg.de/opus4/files/77305/2325967119892925.pdfTest

المؤلفون: Peter J. Millett, Samuel I Rosenberg, Grant J. Dornan, Alex W. Brady, Lucca Lacheta

المصدر: Orthopaedic Journal of Sports Medicine

مصطلحات موضوعية: Orthodontics, Fixation (surgical), all-suture anchor, business.industry, unicortical button, Medicine, subpectoral biceps tenodesis, Orthopedics and Sports Medicine, onlay technique, business, Biceps, Article

الوصف: Background: Subpectoral biceps tenodesis can be performed with cortical fixation using different repair techniques. The goal of this technique is to obtain a strong and stable reduction of biceps tendon in an anatomic position. Purpose/Hypothesis: The purpose of this study was to compare (1) displacement during cyclic loading, (2) ultimate load, (3) construct stiffness, and (4) failure mode of the biceps tenodesis fixation methods using onlay techniques with an all-suture anchor versus an intramedullary unicortical button. It was hypothesized that fixation with all-suture anchors using a Krackow stitch would exhibit biomechanical characteristics similar to those exhibited by fixation with unicortical buttons. Study Design: Controlled laboratory study. Methods: Ten pairs of fresh-frozen cadaveric shoulders (N = 20) were dissected to the humerus, leaving the biceps tendon-muscle unit intact for testing. A standardized subpectoral biceps cortical (onlay) tenodesis was performed using either an all-suture anchor or a unicortical button. The biceps tendon was initially cycled from 5 to 70 N at a frequency of 1.5 Hz. The force on the tendon was then returned to 5 N, and the tendon was pulled until ultimate failure of the construct. Displacement during cyclic loading, ultimate failure load, stiffness, and failure modes were assessed. Results: Cyclic loading resulted in a mean displacement of 12.5 ± 2.5 mm for all-suture anchor fixation and 29.2 ± 9.4 mm for unicortical button fixation ( P = .005). One all-suture anchor fixation and 2 unicortical button fixations failed during cyclic loading. The mean ultimate failure load was 170.4 ± 68.8 N for the all-suture anchor group and 125.4 ± 44.6 N for the unicortical button group ( P = .074), with stiffness 59.3 ± 11.6 N/mm and 48.6 ± 6.8 N/mm ( P = .091), respectively. For the unicortical button, failure occurred by suture tearing through tendon in 100% of the specimens. For the all-suture anchor, failure occurred by suture tearing through tendon in 56% and knot failure in 44% of the specimens. Conclusion: The all-suture anchor fixation using a Krackow stitch for subpectoral biceps tenodesis provided ultimate load and stiffness similar to unicortical button fixation using a nonlocking whipstitch. The all-suture anchor fixation technique was shown to be superior in terms of displacement during cyclic loading when compared with the unicortical button fixation technique. However, the results of this study help to show that the fixation method used on the humeral side is less implicative of the overall construct strength than stitch location and technique, as the biceps tendon tissue and stitch configuration seem to be the limiting factor in subpectoral onlay tenodesis techniques. Clinical Relevance: All-suture anchors have a smaller diameter than traditional suture anchors, can be inserted through curved guides, and preserve humeral bone stock without compromising postoperative imaging. This study supports use of the all-suture anchor fixation technique for subpectoral biceps tenodesis, with high biomechanical fixation strength and low displacement, as an alternative to the subpectoral onlay biceps tenodesis technique.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::0c52cb62b77479bdd3b372b95c789b8eTest
http://europepmc.org/articles/PMC6794656Test

المؤلفون: Navraj S Nagra, N. Zargar, Andrew Carr, R. D. J. Smith

المصدر: Bone & Joint Research

مصطلحات موضوعية: Shoulder, medicine.medical_specialty, Ultimate load, Context (language use), Rotator Cuff, 03 medical and health sciences, 0302 clinical medicine, Suture (anatomy), Mechanical Properties, Medicine, Orthopedics and Sports Medicine, Rotator cuff, Displacement (orthopedic surgery), Fixation (histology), Orthodontics, 030222 orthopedics, business.industry, Research, Failure Mechanisms, All-Suture Anchors, 030229 sport sciences, Surgery, medicine.anatomical_structure, Failure Load, Implant, Total Displacement, business, Cadaveric spasm

الوصف: Objectives All-suture anchors are increasingly used in rotator cuff repair procedures. Potential benefits include decreased bone damage. However, there is limited published evidence for the relative strength of fixation for all-suture anchors compared with traditional anchors. Materials and Methods A total of four commercially available all-suture anchors, the ‘Y-Knot’ (ConMed), Q-FIX (Smith & Nephew), ICONIX (Stryker) and JuggerKnot (Zimmer Biomet) and a traditional anchor control TWINFIX Ultra PK Suture Anchor (Smith & Nephew) were tested in cadaveric human humeral head rotator cuff repair models (n = 24). This construct underwent cyclic loading applied by a mechanical testing rig (Zwick/Roell). Ultimate load to failure, gap formation at 50, 100, 150 and 200 cycles, and failure mechanism were recorded. Significance was set at p < 0.05. Results Overall, mean maximum tensile strength values were significantly higher for the traditional anchor (181.0 N, standard error (se) 17.6) compared with the all-suture anchors (mean 133.1 N se 16.7) (p = 0.04). The JuggerKnot anchor had greatest displacement at 50, 100 and 150 cycles, and at failure, reaching statistical significance over the control at 100 and 150 cycles (22.6 mm se 2.5 versus 12.5 mm se 0.3; and 29.6 mm se 4.8 versus 17.0 mm se 0.7). Every all-suture anchor tested showed substantial (> 5 mm) displacement between 50 and 100 cycles (6.2 to 14.3). All-suture anchors predominantly failed due to anchor pull-out (95% versus 25% of traditional anchors), whereas a higher proportion of traditional anchors failed secondary to suture breakage. Conclusion We demonstrate decreased failure load, increased total displacement, and variable failure mechanisms in all-suture anchors, compared with traditional anchors designed for rotator cuff repair. These findings will aid the surgeon’s choice of implant, in the context of the clinical scenario. Cite this article: N. S. Nagra, N. Zargar, R. D. J. Smith, A. J. Carr. Mechanical properties of all-suture anchors for rotator cuff repair. Bone Joint Res 2017;6:82–89. DOI: 10.1302/2046-3758.62.BJR-2016-0225.R1

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::a8e07dadd646cf97b206ca663dbc5496Test
https://doi.org/10.1302/2046-3758.62.bjr-2016-0225.r1Test

المؤلفون: Jonathan D. Haskel, John Erickson, Justin Rice, Adam E. Hyatt, Frank Chiarappa, James Monica, Aman Dhawan

المصدر: Orthopaedic Journal of Sports Medicine

مصطلحات موضوعية: all-soft, Orthodontics, all-suture, labrum, 030222 orthopedics, Labrum, anchor, business.industry, 030229 sport sciences, glenoid, 03 medical and health sciences, 0302 clinical medicine, Suture (anatomy), Medicine, Orthopedics and Sports Medicine, business, Suture anchors

الوصف: Background: All–soft tissue suture anchors provide advantages of decreased removal of bone and decreased glenoid volume occupied compared with traditional tap or screw-in suture anchors. Previous published data have led to biomechanical concerns with the use of first-generation all-soft suture anchors. Purpose/Hypothesis: The purpose of this study was to evaluate the load to 2-mm displacement and ultimate load to failure of a second-generation all-soft suture anchor, compared with a first-generation anchor and a traditional PEEK (polyether ether ketone) anchor. The null hypothesis was that the newer second-generation anchor will demonstrate no difference in loads to 2-mm displacement after cycling compared with first-generation all-soft suture anchors. Study Design: Controlled laboratory study. Methods: Twenty human cadaveric glenoids were utilized to create 97 total suture anchor sites, and 1 of 3 anchors were randomized and placed into each site: (1) first-generation all-soft suture anchor (Juggerknot; Biomet), (2) second-generation all-soft suture anchor (Suturefix; Smith & Nephew), and (3) a control PEEK anchor (Bioraptor; Smith & Nephew). After initial cyclic loading, load to 2 mm of displacement and ultimate load to failure were measured for each anchor. Results: After cyclic loading, the load to 2-mm displacement was significantly less in first-generation anchors compared with controls ( P < .01). However, the load to 2-mm displacement was significantly greater in second-generation anchors compared with controls ( P < .01). There was no difference in ultimate load to failure between the first- and second-generation all-soft suture anchors ( P > .05). Conclusion: The newer generation all-soft suture anchors with a theoretically more rigid construct and deployment configuration demonstrate biomechanical characteristics (specifically, with load to 2-mm displacement after cyclic loading) that are improved over first-generation all-soft suture anchors and similar to a traditional solid tap-in anchor. The configuration of these newer generation all-soft suture anchors appears to mitigate the biomechanical concerns of decreased load to failure with first-generation all–soft tissue suture anchors. Clinical Relevance: The theoretical advantages of all-soft anchors may be particularly valuable in revision surgery or in cases where multiple anchors are being placed into a small anatomic area.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::71fd25dc6242202bb4f5d10ea8311c82Test
https://doi.org/10.1177/2325967117717010Test