Pullout strength and failure mode of industrially manufactured and self-made all-suture anchors: a biomechanical analysis.
Bankart repair
Rotator cuff repair
all-suture anchor
biomechanics
cost-effectiveness
porcine bone
Journal
Journal of shoulder and elbow surgery
ISSN: 1532-6500
Titre abrégé: J Shoulder Elbow Surg
Pays: United States
ID NLM: 9206499
Informations de publication
Date de publication:
Jul 2020
Jul 2020
Historique:
received:
10
07
2019
revised:
05
12
2019
accepted:
10
12
2019
pubmed:
22
3
2020
medline:
24
11
2020
entrez:
22
3
2020
Statut:
ppublish
Résumé
This study presents a new technique for assembling an all-suture anchor from existing medical products. The biomechanical characteristics of this self-made anchor (SMA) are compared with those of an industrially manufactured all-suture anchor. The SMAs were made from established medical products (FiberWire #2 and 2-mm FiberTape; Arthrex, Naples, FL, USA). Pretesting was performed in biphasic polyurethane foam blocks. In the next step, 10 SMAs and 10 industrially made anchors (IMAs; 1.8-mm double-loaded Y-Knot Flex all-suture anchor; ConMed Linvatec, Largo, FL, USA) were applied with an insertion tool and tested in fresh porcine femora using a servohydraulic testing system, with a preload of 10 N and a displacement rate of 12.5 mm/s. Pullout strength and failure mode were recorded. The mean load at failure in the foam blocks was 459 ± 124 N in the SMA group and 538 ± 83 N in the IMA group. In porcine bone, failure occurred at 461 ± 102 N in the SMA group and 431 ± 135 N in the IMA group. The differences in pullout strength between the 2 types of anchor were not statistically significant, either in the foam blocks (P = .17) or in porcine bone (P = .62). A handmade all-suture anchor using 2 high-strength sutures woven into a 2-mm strip of high-strength tape did not show statistically different failure loads in polyurethane foam or in porcine metaphyseal bone in comparison with a commercially produced double-loaded all-suture anchor. The principal mode of failure in porcine bone in both groups was anchor pullout.
Sections du résumé
BACKGROUND
BACKGROUND
This study presents a new technique for assembling an all-suture anchor from existing medical products. The biomechanical characteristics of this self-made anchor (SMA) are compared with those of an industrially manufactured all-suture anchor.
METHODS
METHODS
The SMAs were made from established medical products (FiberWire #2 and 2-mm FiberTape; Arthrex, Naples, FL, USA). Pretesting was performed in biphasic polyurethane foam blocks. In the next step, 10 SMAs and 10 industrially made anchors (IMAs; 1.8-mm double-loaded Y-Knot Flex all-suture anchor; ConMed Linvatec, Largo, FL, USA) were applied with an insertion tool and tested in fresh porcine femora using a servohydraulic testing system, with a preload of 10 N and a displacement rate of 12.5 mm/s. Pullout strength and failure mode were recorded.
RESULTS
RESULTS
The mean load at failure in the foam blocks was 459 ± 124 N in the SMA group and 538 ± 83 N in the IMA group. In porcine bone, failure occurred at 461 ± 102 N in the SMA group and 431 ± 135 N in the IMA group. The differences in pullout strength between the 2 types of anchor were not statistically significant, either in the foam blocks (P = .17) or in porcine bone (P = .62).
CONCLUSION
CONCLUSIONS
A handmade all-suture anchor using 2 high-strength sutures woven into a 2-mm strip of high-strength tape did not show statistically different failure loads in polyurethane foam or in porcine metaphyseal bone in comparison with a commercially produced double-loaded all-suture anchor. The principal mode of failure in porcine bone in both groups was anchor pullout.
Identifiants
pubmed: 32197807
pii: S1058-2746(19)30837-7
doi: 10.1016/j.jse.2019.12.007
pii:
doi:
Substances chimiques
Polyurethanes
0
polyurethane foam
9009-54-5
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1479-1483Informations de copyright
Copyright © 2019 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.