Biomechanical properties of a suture anchor system from human allogenic mineralized cortical bone matrix for rotator cuff repair.
Allogenic mineralized suture anchor
Biomechanical analysis
High-resolution peripheral quantitative computed tomography
Rotator cuff reconstruction
Shoulder
Shoulder surgery
Suture anchor
Journal
BMC musculoskeletal disorders
ISSN: 1471-2474
Titre abrégé: BMC Musculoskelet Disord
Pays: England
ID NLM: 100968565
Informations de publication
Date de publication:
05 May 2022
05 May 2022
Historique:
received:
12
09
2021
accepted:
25
04
2022
entrez:
5
5
2022
pubmed:
6
5
2022
medline:
10
5
2022
Statut:
epublish
Résumé
Suture anchors (SAs) made of human allogenic mineralized cortical bone matrix are among the newest developments in orthopaedic and trauma surgery. Biomechanical properties of an allogenic mineralized suture anchor (AMSA) are not investigated until now. The primary objective was the biomechanical investigation of AMSA and comparing it to a metallic suture anchor (MSA) and a bioabsorbable suture anchor (BSA) placed at the greater tuberosity of the humeral head of cadaver humeri. Additionally, we assessed the biomechanical properties of the SAs with bone microarchitecture parameters. First, bone microarchitecture of 12 fresh frozen human cadaver humeri from six donors was analyzed by high-resolution peripheral quantitative computed tomography. In total, 18 AMSAs, 9 MSAs, and 9 BSAs were implanted at a 60° angle. All three SA systems were systematically implanted alternating in three positions within the greater tuberosity (position 1: anterior, position 2: central, position 3: posterior) with a distance of 15 mm to each other. Biomechanical load to failure was measured in a uniaxial direction at 135°. Mean age of all specimens was 53.6 ± 9.1 years. For all bone microarchitecture measurements, linear regression slope estimates were negative which implies decreasing values with increasing age of specimens. Positioning of all three SA systems at the greater tuberosity was equally distributed (p = 0.827). Mean load to failure rates were higher for AMSA compared to MSA and BSA without reaching statistical significance between the groups (p = 0.427). Anchor displacement was comparable for all three SA systems, while there were significant differences regarding failure mode between all three SA systems (p < 0.001). Maximum load to failure was reached in all cases for AMSA, in 44.4% for MSA, and in 55.6% for BSA. Suture tear was observed in 55.6% for MSA and in 22.2% for BSA. Anchor breakage was solely seen for BSA (22.2%). No correlations were observed between bone microarchitecture parameters and load to failure rates of all three suture anchor systems. The AMSA showed promising biomechanical properties for initial fixation strength for RCR. Since reduced BMD is an important issue for patients with chronic rotator cuff lesions, the AMSA is an interesting alternative to MSA and BSA. Also, the AMSA could improve healing of the enthesis.
Sections du résumé
BACKGROUND
BACKGROUND
Suture anchors (SAs) made of human allogenic mineralized cortical bone matrix are among the newest developments in orthopaedic and trauma surgery. Biomechanical properties of an allogenic mineralized suture anchor (AMSA) are not investigated until now. The primary objective was the biomechanical investigation of AMSA and comparing it to a metallic suture anchor (MSA) and a bioabsorbable suture anchor (BSA) placed at the greater tuberosity of the humeral head of cadaver humeri. Additionally, we assessed the biomechanical properties of the SAs with bone microarchitecture parameters.
METHODS
METHODS
First, bone microarchitecture of 12 fresh frozen human cadaver humeri from six donors was analyzed by high-resolution peripheral quantitative computed tomography. In total, 18 AMSAs, 9 MSAs, and 9 BSAs were implanted at a 60° angle. All three SA systems were systematically implanted alternating in three positions within the greater tuberosity (position 1: anterior, position 2: central, position 3: posterior) with a distance of 15 mm to each other. Biomechanical load to failure was measured in a uniaxial direction at 135°.
RESULTS
RESULTS
Mean age of all specimens was 53.6 ± 9.1 years. For all bone microarchitecture measurements, linear regression slope estimates were negative which implies decreasing values with increasing age of specimens. Positioning of all three SA systems at the greater tuberosity was equally distributed (p = 0.827). Mean load to failure rates were higher for AMSA compared to MSA and BSA without reaching statistical significance between the groups (p = 0.427). Anchor displacement was comparable for all three SA systems, while there were significant differences regarding failure mode between all three SA systems (p < 0.001). Maximum load to failure was reached in all cases for AMSA, in 44.4% for MSA, and in 55.6% for BSA. Suture tear was observed in 55.6% for MSA and in 22.2% for BSA. Anchor breakage was solely seen for BSA (22.2%). No correlations were observed between bone microarchitecture parameters and load to failure rates of all three suture anchor systems.
CONCLUSIONS
CONCLUSIONS
The AMSA showed promising biomechanical properties for initial fixation strength for RCR. Since reduced BMD is an important issue for patients with chronic rotator cuff lesions, the AMSA is an interesting alternative to MSA and BSA. Also, the AMSA could improve healing of the enthesis.
Identifiants
pubmed: 35513813
doi: 10.1186/s12891-022-05371-0
pii: 10.1186/s12891-022-05371-0
pmc: PMC9069722
doi:
Substances chimiques
Amsacrine
00DPD30SOY
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
422Informations de copyright
© 2022. The Author(s).
Références
Knee Surg Sports Traumatol Arthrosc. 2007 Dec;15(12):1486-8
pubmed: 17440708
Clin Biomech (Bristol, Avon). 2018 May;54:132-136
pubmed: 29587146
Arthroscopy. 1995 Feb;11(1):119-23
pubmed: 7727005
Arch Orthop Trauma Surg. 2010 Aug;130(8):1037-40
pubmed: 20526849
Lancet. 2019 Jan 26;393(10169):364-376
pubmed: 30696576
Knee Surg Sports Traumatol Arthrosc. 2012 Jun;20(6):1003-11
pubmed: 22270674
Arthroscopy. 2005 Sep;21(9):1149
pubmed: 16171647
Clin Orthop Relat Res. 2010 Dec;468(12):3406-12
pubmed: 20521128
Am J Sports Med. 2015 Dec;43(12):2907-12
pubmed: 26482545
Arthroscopy. 2020 Apr;36(4):1009-1010
pubmed: 32247400
Biologicals. 2001 Jun;29(2):59-66
pubmed: 11580210
Clin Biomech (Bristol, Avon). 2015 Mar;30(3):243-7
pubmed: 25686676
J Bone Joint Surg Am. 2002 Dec;84(12):2152-60
pubmed: 12473702
J Shoulder Elbow Surg. 2014 Dec;23(12):1913-1921
pubmed: 25441568
Arthroscopy. 1997 Jun;13(3):340-5
pubmed: 9195031
Am J Sports Med. 2010 Mar;38(3):564-9
pubmed: 20118499
Knee Surg Sports Traumatol Arthrosc. 2015 Feb;23(2):530-41
pubmed: 25573661
Lancet Diabetes Endocrinol. 2019 Jan;7(1):34-43
pubmed: 30503163
J Orthop Res. 2012 May;30(5):769-74
pubmed: 22068696
Arthroscopy. 2017 Jan;33(1):68-74
pubmed: 27476640
Biologicals. 1999 Sep;27(3):195-201
pubmed: 10652175
Arthroscopy. 2001 Jan;17(1):31-7
pubmed: 11154364
Arthroscopy. 2019 Apr;35(4):1064-1071
pubmed: 30857903
Am J Sports Med. 2012 Jun;40(6):1424-30
pubmed: 21856927
Am J Sports Med. 2004 Sep;32(6):1466-73
pubmed: 15310572
Clin Biomech (Bristol, Avon). 2019 Jan;61:70-78
pubmed: 30502638
Bone Joint Res. 2017 Feb;6(2):82-89
pubmed: 28167489
J Clin Med. 2022 Mar 03;11(5):
pubmed: 35268475
J Bone Joint Surg Am. 1996 Sep;78(9):1391-6
pubmed: 8816656
J Orthop. 2013 Feb 26;10(1):8-12
pubmed: 24403741
J Bone Miner Res. 2017 Jul;32(7):1505-1513
pubmed: 28294405
Am J Sports Med. 2017 May;45(6):1283-1288
pubmed: 28272899
Arthroscopy. 2015 Feb;31(2):184-90
pubmed: 25442647
Arthroscopy. 2007 Aug;23(8):904.e1-3
pubmed: 17681214
J Bone Joint Surg Am. 2017 May 17;99(10):855-864
pubmed: 28509826
J Orthop Surg Res. 2014 Aug 22;9:48
pubmed: 25148925
J Shoulder Elbow Surg. 2016 Aug;25(8):1280-7
pubmed: 26948004
Arch Orthop Trauma Surg. 2021 Apr 8;:
pubmed: 33834287
Arch Orthop Trauma Surg. 2009 Mar;129(3):373-9
pubmed: 18607610
J Shoulder Elbow Surg. 2004 May-Jun;13(3):333-7
pubmed: 15111905
Am J Sports Med. 2011 Oct;39(10):2099-107
pubmed: 21813440
Am J Sports Med. 2005 Dec;33(12):1918-23
pubmed: 16314667
J Orthop Res. 2018 Dec;36(12):3318-3327
pubmed: 30175855
Expert Rev Med Devices. 2011 May;8(3):377-87
pubmed: 21542709
Life (Basel). 2021 May 24;11(6):
pubmed: 34073841
Arthroscopy. 2009 Feb;25(2):192-9
pubmed: 19171280
J Orthop Surg Res. 2019 Jan 9;14(1):12
pubmed: 30626411
Orthop J Sports Med. 2017 Oct 25;5(10):2325967117734517
pubmed: 29124078
Arthroscopy. 2018 Oct;34(10):2784-2795
pubmed: 30181056
Arthroscopy. 2020 Apr;36(4):1000-1008
pubmed: 31926271
J Bone Joint Surg Am. 2018 Nov 7;100(21):1854-1863
pubmed: 30399080
Am J Sports Med. 2020 Jul;48(9):2151-2160
pubmed: 32543880
J Bone Joint Surg Am. 2013 Mar 20;95(6):507-11
pubmed: 23407607
Am J Orthop (Belle Mead NJ). 2012 Feb;41(2):92-4
pubmed: 22482095
Science. 1965 Nov 12;150(3698):893-9
pubmed: 5319761
Clin Orthop Relat Res. 2006 Oct;451:236-41
pubmed: 16702922
J Bone Joint Surg Am. 2003 Nov;85(11):2190-8
pubmed: 14630852
J Bone Joint Surg Am. 2019 Jun 19;101(12):1050-1060
pubmed: 31220021
Knee Surg Sports Traumatol Arthrosc. 2013 Jul;21(7):1647-54
pubmed: 23604175
Knee Surg Sports Traumatol Arthrosc. 2018 Jan;26(1):136-145
pubmed: 28647842
Arthroscopy. 2007 Oct;23(10):1124-6
pubmed: 17916480