Biomechanical Evaluation of Proximal Hamstring Repair: All-Suture Anchor Versus Titanium Suture Anchor.

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;

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.

Informations de copyright

© The Author(s) 2020.

Déclaration de conflit d'intérêts

One or more of the authors has declared the following potential conflict of interest or source of funding: The University of Connecticut Health Center/UConn Musculoskeletal Institute has received direct funding and material support for this study from Arthrex. A.O. received material support from Arthrex during the conduct of this study. A.B.I. has received consulting fees from Arthrosurface, Arthrex, and Medi. K.B. has received consulting fees from Arthrex. A.D.M. has received grant support and consulting fees from Arthrex and honoraria from Arthrosurface. K.C. has received educational support from Arthrex and Pylant Medical, speaking fees from Arthrex, consulting fees from Johnson & Johnson, and hospitality payments from Biomet and Smith & Nephew. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.