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Sutures, pull out strength, anchors

N S Nagra, N Zargar, R D J Smith, A J Carr
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)...
February 2017: Bone & Joint Research
Susumu Tokunaga, Yoshihiro Abe
Collateral ligaments are difficult to repair due to large amount of fraying in detached ligaments and attenuated stumps that may not provide enough strength after the repair. Although strong locking sutures are used to repair the ligament with proper tension, these damages can cause pull-out failure or relaxation of the repaired ligaments even from undersized load that may extend postoperative splinting or casting time. Furthermore, current suture techniques can repair varus or valgus instability of the elbow and radial or ulnar instability of the fingers, but these techniques do not offer rotatory stability of these areas...
June 2016: Journal of Hand Surgery Asian-Pacific Volume
N Schmelzer-Schmied
OBJECTIVE: The goal of this operation technique is a stable refixation of the triangular fibrocartilage complex (TFCC) to the fovea ulnaris. The stability of the distal radio-ulnar joint (DRUJ) should be re-established. The patients pain and the feeling of instability should be reduced. INDICATIONS: Lesions of the foveal component of the TFCC resulting in DRUJ instability. Combined lesions of both components of the TFCC. Complete detachment of the TFCC from the ulna either without fracture of the styloid process of the ulna or with fracture (floating styloid)...
August 2016: Operative Orthopädie und Traumatologie
Sung Jong Woo, Midum Jegal, Min Jong Park
BACKGROUND: Disruption of the triangular fibrocartilage complex (TFCC) foveal insertion can lead to distal radioulnar joint (DRUJ) instability accompanied by ulnar-sided pain, weakness, snapping, and limited forearm rotation. We investigated the clinical outcomes of patients with TFCC foveal tears treated with arthroscopic-assisted repair. MATERIALS AND METHODS: Twelve patients underwent foveal repair of avulsed TFCC with the assistance of arthroscopy between 2011 and 2013...
May 2016: Indian Journal of Orthopaedics
Qi Guo, Chunbao Li, Wei Qi, Hongliang Li, Xi Lu, Xuezhen Shen, Feng Qu, Yujie Liu
PURPOSE: The aim of this study was to evaluate biomechanical properties of a new type of suture anchors constructed of human cortical allograft bone and compare it with the similar standard titanium screw anchor for rotator cuff tears in sheep humerus model. METHODS: Twenty-four paired sheep humeri were harvested from 12 male sheep aged 18 months. Specimens were divided into cortical bone anchor group and titanium screw anchor group. The anchors loaded with two sutures were placed at the footprint of infraspinatus tendon...
September 2016: International Orthopaedics
Olaf Lorbach, Christian Trennheuser, Matthias Kieb, Turgay Efe, Dieter Kohn, Konstantinos Anagnostakos
PURPOSE: Evaluation of the biomechanical performance of repairs of 25 % (Fox/Romeo II) and 50 % (Fox/Romeo III) full-thickness subscapularis tears using a single-suture anchor. METHODS: Six pairs of human cadaver specimens were used for the testing. Artificial subscapularis tears were created in order to simulate a 25 % (6) and a 50 % (6) full-thickness tear. The reconstructions were made with a double-loaded suture anchor (5.5-mm Bio-Corkscrew with two No. 2 Fiberwire) creating a double-mattress suture repair...
December 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Martin C Jordan, Vanessa Schmitt, Hendrik Jansen, Rainer H Meffert, Stefanie Hoelscher-Doht
PURPOSE: To compare the biomechanical properties of the modified Kessler, Lahey, Adelaide, and Becker repairs, which are marked by either a locking-loop or a cross-lock configuration. METHODS: Ninety-six lacerated porcine flexor tendons were repaired using the respective core suture and an epitendinous repair. Biomechanical testing was conducted under static and cyclic loads. Parameters of interest were 2-mm gap formation force, displacement during different loads, stiffness, maximum force, and mode of failure...
September 2015: Journal of Hand Surgery
Volker Braunstein, Ben Ockert, Markus Windolf, Christoph M Sprecher, Wolf Mutschler, Andreas Imhoff, Lukas Karl Leo Postl, Peter Biberthaler, Chlodwig Kirchhoff
BACKGROUND: Rotator cuff tears are of increasing clinical impact in the physically active elderly patients. Recent research revealed, that a high percentage of these patients present with significant loss of bone mineral density at the insertion site of the rotator cuff, thereby compromising suture anchorage for operative repair. We therefore hypothesized that augmentation of suture anchors improves biomechanical properties in low bone quality. METHODS: 28 osteoporotic humeral heads were included in this biomechanical study...
March 2015: Clinical Biomechanics
Myung Ku Kim, Suk In Na, Jong Min Lee, Ju Yong Park
PURPOSE: The use of graft tissue fixation using bioabsorbable interference screws (BISs) in anterior cruciate ligament (ACL) reconstruction offers various advantages, but limited pullout strength. Therefore, additional tibial fixation is essential for aggressive rehabilitation. We hypothesized that additional graft tissue fixation using bioabsorbable suture anchors (BSA) would provide sufficient pull-out strength. MATERIALS AND METHODS: Twenty four fresh frozen porcine distal femur and patellar tendon preparations were used...
May 2014: Yonsei Medical Journal
Elizabeth J Barrett, Amelia S Munsterman, R Reid Hanson, Robert L Jackson
OBJECTIVE: To compare in vitro strength and failure characteristics of a tendon implant against a 3 loop pulley suture pattern for equine superficial digital flexor tendon (SDFT) laceration repair. STUDY DESIGN: Experimental. STUDY POPULATION: Cadaveric equine forelimb SDFT (n = 16). METHODS: One tendon of each of 8 pair of SDFT was randomly selected for repair with either the 3-loop pulley (3LP) suture pattern using 2 polydioxanone or with 4 stainless steel suture and anchor implants (SA)...
August 2014: Veterinary Surgery: VS
David Awogni, Guillaume Chauvette, Marie-Line Lemieux, Frédéric Balg, Ève Langelier, Jean-Pascal Allard
Chronic insertional tendinopathy of the Achilles tendon is a frequent and disabling pathologic entity. Operative treatment is indicated for patients for whom nonoperative management has failed. The treatment can consist of the complete detachment of the tendon insertion and extensive debridement. We biomechanically tested a new operative technique that uses buttons for fixation of the Achilles tendon insertion on the posterior calcaneal tuberosity and compared it with 2 standard bone anchor techniques. A total of 40 fresh-frozen cadaver specimens were used to compare 3 fixation techniques for reinserting the Achilles tendon: single row anchors, double row anchors, and buttons...
March 2014: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Christopher A Brown, Daniel Hurwit, Anthony Behn, Kenneth J Hunt
BACKGROUND: Anatomic repair is indicated for patients who have recurrent lateral ankle instability despite nonoperative measures. HYPOTHESIS: There is no difference in repair stiffness, failure torque, or failure angle between specimens repaired with all-soft suture anchors versus the modified Broström-Gould technique with sutures only. STUDY DESIGN: Controlled laboratory study. METHODS: In 10 matched pairs of human cadaveric ankles, the anterior talofibular ligament (ATFL) was incised from its origin on the fibula...
February 2014: American Journal of Sports Medicine
Mihir J Desai, William C Hutton, Claudius D Jarrett
PURPOSE: To compare the biomechanical strength of a knotless suture anchor repair and the traditional outside-in repair of peripheral triangular fibrocartilage complex (TFCC) tears in a cadaveric model. METHODS: We dissected the distal ulna and TFCC from 6 matched cadaveric wrist pairs and made iatrogenic complete peripheral TFCC tears in each wrist. In 6 wrists, the TFCC tears were repaired using the standard outside-in technique using 2 2-0 polydioxane sutures placed in a vertical mattress fashion...
November 2013: Journal of Hand Surgery
Tim Dwyer, Thomas L Willett, Andrew P Dold, Massimo Petrera, David Wasserstein, Danny B Whelan, John S Theodoropoulos
PURPOSE: The purpose of this study was to evaluate the biomechanical behavior of an all-suture glenoid anchor in comparison with a more conventional screw-in glenoid anchor, with regard to maximum load to failure and tensile displacement. METHODS: All mechanical testing was performed using an Instron ElectroPuls E1000 mechanical machine, with a 10 N pre-load and displacement rate of 10 mm/min. Force-displacement curves were generated, with calculation of maximum load, maximum displacement, displacement at 50 N and stiffness...
February 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Matthias J Feucht, Eduardo Grande, Johannes Brunhuber, Nikolaus Rosenstiel, Rainer Burgkart, Andreas B Imhoff, Sepp Braun
BACKGROUND: Posterior medial meniscus root (PMMR) tears have a serious effect on knee joint biomechanics. Currently used techniques for refixation of the PMMR include the transtibial pull-out repair (TP) and suture anchor repair (SA). These techniques have not been compared biomechanically. HYPOTHESIS: The SA technique provides superior biomechanical properties compared with the TP technique. STUDY DESIGN: Controlled laboratory study. METHODS: A total of 24 fresh-frozen porcine tibiae with attached intact medial menisci were used...
January 2014: American Journal of Sports Medicine
Sebastian Siebenlist, Arne Buchholz, Julian Zapf, Gunther H Sandmann, Karl F Braun, Frank Martetschläger, Alexander Hapfelmeier, Tobias M Kraus, Andreas Lenich, Peter Biberthaler, Florian Elser
PURPOSE: The aim of this biomechanical in vitro study was to compare the novel technique of double intramedullary cortical button (DICB) fixation with the well-established method of suture anchor (SA) fixation for distal biceps tendon repair. METHODS: A matched-pair analysis (24 human cadaveric radii) was performed with respect to cyclic loadings and failure strengths. Twelve specimens per group were cyclically loaded for 1,000 cycles at 1.5 Hz from 5 to 50 N and from 5 to 100 N, respectively...
March 2015: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Jennifer Y Chu, Tony Chen, Hani A Awad, John Elfar, Warren C Hammert
PURPOSE: One goal in repairing zone 1 flexor digitorum profundus (FDP) injuries is to create a tendon-bone construct strong enough to allow early rehabilitation while minimizing morbidity. This study compares an all-inside suture repair technique biomechanically with pull-out suture and double-suture anchor repairs. METHODS: Repairs were performed on 30 cadaver fingers. In all-inside suture repairs (n = 8), the FDP tendon was attached to bone with two 3-0 Ethibond sutures and tied over the dorsal aspect of distal phalanx...
June 2013: Journal of Hand Surgery
Onur Hapa, Ertuğrul Akşahin, Mehmet Erduran, Serkan Davul, Hasan Havitçioğlu, Robert F LaPrade, Ergun Bozdağ, Emin Sünbüloğlu
PURPOSE: Comparison of the mechanical characteristics of meniscal repair fixation using horizontal sutures and six different sutures under submaximal cyclic and load to failure test conditions may aid physicians in selecting a suture type. METHODS: A 2-cm long anteroposterior vertical longitudinal incision was created in six groups of bovine medial menisci. Lesions were repaired using a No. 2 suture either composed of polyester or polyester and ultra high-molecular weight polyethylene (UHMWPE), or UHMWPE and polydioxanone or pure UHMWPE...
December 2013: Knee
Du Hyun Ro, Goo Hyun Baek, Hyun Sik Gong
Complete distal biceps tendon rupture causes a considerable loss of supination and flexion strength, and thus, surgical repair is indicated in active individuals. To reduce the risk of injury to the radial nerve in the confined space where the distal biceps inserts into the radius, several surgical methods have been reported, such as, pull out sutures, two-incision techniques, and the use of suture anchors. Here, we describe our modified single-incision distal biceps tendon repair technique using three suture anchors, which widens the bone-tendon contact surface and simplifies tensioning of the tendon attachment...
2012: Hand Surgery
Robert Y Wang, Robert A Arciero, Elifho Obopilwe, Augustus D Mazzocca
The objective of the study was to compare the load to failure between a retro screw (RS) and a standard interference screw (IS) for tibial-sided anterior cruciate ligament (ACL) fixation. We used 20 bovine tibia and extensor tendons for the study. A group of 10 specimens underwent IS fixation while the other 10 underwent RS fixation. Within each group, five specimens had graft suture in contact (interdigitating) with the screw threads. All specimens were tested on the MTS 858 Mini Bionix II (MTS Systems, Shakopee, MN)...
July 2012: Journal of Knee Surgery
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