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Sutures, pull out strength, anchors

Jonas Pogorzelski, Kyle J Muckenhirn, Justin J Mitchell, J Christoph Katthagen, Jason M Schon, Kimi D Dahl, Alan M Hirahara, Joshua S Dines, Christopher R Adams, Thomas Dooney, Patrick J Denard, Travis Lee Turnbull, Peter J Millett
BACKGROUND: Superior capsular reconstruction (SCR) was recently introduced as a treatment for irreparable superior rotator cuff tears in younger patients. Purpose/Hypothesis: The purpose was to assess the biomechanical strength of 3 methods for fixation of the graft to the glenoid for SCR. It was hypothesized that a 4-anchor technique would provide greater load to failure than 3-anchor techniques. STUDY DESIGN: Controlled laboratory study. METHODS: Thirty-six cadaveric specimens were randomized into 3 groups of previously established glenoid-side graft fixation techniques: (1) three 3...
March 2018: American Journal of Sports Medicine
Mostafa Mahmoud, Motaz Elian, Abdalah Seif Elnasr
Injuries to flexor tendons in zone I has always been challenging during repair. Over the time several techniques were developed and modified to achieve the highest repair strength and thus the best functional outcome. These techniques vary from pull-out sutures with internal and external fixation to the use of bone anchors. All techniques were accompanied with advantages and disadvantages as well as postoperative morbidities related to certain techniques. In the present technique we introduce a subperiosteal pull-out suturing technique...
December 2017: Techniques in Hand & Upper Extremity Surgery
Jun Kawakami, Nobuyuki Yamamoto, Hideaki Nagamoto, Eiji Itoi
PURPOSE: To investigate the minimum distance between the anchors without decreasing the pullout strength using the polyurethane foams and the porcine bones. METHODS: Metal screw-type anchors and PEEK (polyether ether ketone) coil-type anchors were used. Two same-type suture anchors were placed into the polyurethane foams and porcine bones. The polyurethane foams were 3 different densities simulating severe osteoporosis, osteoporosis, and normal bone. The distances between the centers of anchors were set at 4, 6, 8, and 10 mm...
February 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Marjorie L Pilkinton, Gregory C Levine, Laura Bennett, Harvey A Winkler, Dara F Shalom, Peter S Finamore
INTRODUCTION AND HYPOTHESIS: We aimed to assess the pull-out strength of barbed and nonbarbed sutures used in sacrocolpopexy mesh fixation. We hypothesized there are no differences in the force needed to dislodge mesh from tissue using barbed and nonbarbed sutures of similar size. METHODS: Using the rectus fascia of three unembalmed cadavers, a 6 × 3 cm strip of polypropylene mesh was anchored to the fascia with sutures. The barbed sutures investigated were 2-0 V-Loc 180 (nine trials) and 3-0 bidirectional Quill™ SRS PDO (five trials)...
January 2018: International Urogynecology Journal
Martin J Carney, Tim Matatov, Matthew Freeman, John Miller, Rahul Vemula, Jason Schuster, Michael Dancisak, John Lindsey, Guenevere Rae
INTRODUCTION: The medial thighplasty is a procedure where patients may attain superior mobility, hygiene, and cosmesis. Most surgeons use attachment of the superficial fascial system (SFS) of the thigh flap to the Colles fascia, whereas others attach the SFS to the pubic ramus periosteum. Because of a high complication profile, we aim to elucidate the clinical, biomechanical, and anatomic qualities of the Colles fascia versus the pubic ramus periosteum. MATERIALS AND METHODS: We performed a 17-year retrospective review documenting clinical complications, a biomechanical analysis of sutures placed in different tissue layers of the thigh, and a histologic analysis surrounding the ischiopubic ramus...
June 2017: Annals of Plastic Surgery
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
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