Basic ScienceBiomechanical analysis of conventional anchor revision after all-suture anchor pullout: a human cadaveric shoulder model
Section snippets
Methods
A biomechanical investigation was performed, and a total of 10 human humeral bones (5 matched pairs) were collected from donors aged between 50 and 73 years. Each specimen was scanned using a 16-row computed tomography scanner (Brilliance 16 CT; Philips Healthcare, Hamburg, Germany) with a solid calibration phantom (Bone Density Calibration Phantom; QRM, Möhrendorf, Germany) to determine the volumetric bone mineral density in terms of calcium hydroxyapatite (in milligrams per cubic centimeter)
Results
Determination of volumetric bone mineral density revealed similar values in both groups (126 ± 25 mg/cm3 in ASA/revision group [n = 5] and 127 ± 30 mg/cm3 [n = 5] in 4.5-mm conventional anchor group; P = .81). Revision with the 5.5-mm conventional anchor system at the previous drilling site worked without fail; thus, biomechanical testing was possible in all specimens. All tested anchors failed via anchor pullout during biomechanical testing.
Biomechanical comparison of all 3 tested anchor types
Discussion
This study demonstrates that implantation of a 5.5-mm conventional anchor at the exact site where ASA pullout occurred is possible and provides similar biomechanical properties. Anchor pullout, while not being the most common failure mechanism following rotator cuff repair, is a critical problem in suture anchors, which can lead to rotator cuff instability.20, 21, 22 Whereas conventional anchors are concentrically shaped and their corresponding cortical implantation hole matches the largest
Conclusion
This study demonstrates that there is no difference in load to failure between ASAs and conventional anchors. Furthermore, if pullout of an ASA occurs, adequate fixation can be achieved with a 5.5-mm anchor placed at the exact location of pullout without compromising ultimate fixation.
Disclaimer
ConMed provided the anchors used in this study. The authors, their immediate families, and any research foundations with which they are affiliated have not received any financial payments or other benefits from any commercial entity related to the subject of this article.
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Cited by (0)
Approval of the institutional review board was obtained from the Ethical Review Committee (Hamburg, Germany; study no. WF-27/17).