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Evaluation of BioCorkscrew and Bioknotless RC suture anchor rotator cuff repair fixation: an in vitro biomechanical study

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

This in vitro biomechanical study used cadaveric specimens to compare the rotator cuff repair fixation provided by BioCorkscrew and Bioknotless RC suture anchors. Three cm wide by 1-cm long full-thickness supraspinatus defects were repaired using either two BioCorkscrew suture anchors with combined vertical and horizontal mattress sutures (n = 7) or three Bioknotless RC suture anchors with simple sutures (n = 7). Therefore, the BioCorkscrew suture anchor group had two sutures per anchor (four total sutures), while the Bioknotless RC suture anchor group had one suture per anchor (three total sutures). Two-phase cyclic (5–100 N, 1,000 cycles and 5–180 N, 2,000 cycles) and load to failure tests (31 mm/s) were performed. Non-parametric statistics were used to compare group differences (P < 0.05). All of the BioCorkscrew group specimens (seven of seven) completed the two phase cyclic test regimen without failure or gapping ≥ 5 mm, compared to only three of seven of the Bioknotless RC group (Fisher’s Exact test = 0.03). Groups did not differ for repair site gapping during the 5–100 N cyclic test phase (Fisher’s Exact test = 0.77), however more of the Bioknotless RC group displayed gapping ≥ 5 mm during the 5–180 N cyclic test phase than the BioCorkscrew group (P = 0.02). The BioCorkscrew group also displayed greater yield load during load to failure testing (492.2 ± 204 N vs. 296.4 ± 155 N, P = 0.03). In this in vitro biomechanical study, the BioCorkscrew group with combined vertical and horizontal mattress sutures displayed greater cyclic test survival, less repair site gapping, and superior yield load compared to the Bioknotless RC group with simple sutures. These results in human cadaveric rotator cuff-humerus specimens suggest better immediate post-operative repair site strength and a reduced need for post-operative restrictions. Clinical studies are needed to determine how these rotator cuff repair modes withstand the forces of early rehabilitation and activities of daily living that potentially influence patient outcomes.

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References

  1. Anderson SD (2006) Practical light embalming technique for use in the surgical fresh tissue dissection laboratory. Clin Anat 19(1):8–11

    Article  PubMed  Google Scholar 

  2. Barber FA, Cawley P, Prudich JF (1993) Suture anchor failure strength—an in vivo study. Arthroscopy 9:647–652

    Article  PubMed  CAS  Google Scholar 

  3. Barber FA, Herbert MA, Click JN (1996) Suture anchor strength revisited. Arthroscopy 12:32–38

    Article  PubMed  CAS  Google Scholar 

  4. Burkhart SS (1998) Biomechanics of rotator cuff repairs: Converting the ritual to a science. Instr Course Lect 47:43–50

    PubMed  CAS  Google Scholar 

  5. Burkhart SS (1995) The deadman theory of suture anchors: observations along a south Texas fence line. Arthroscopy 11(1):119–123

    Article  PubMed  CAS  Google Scholar 

  6. Burkhart SS, Fischer SP, Nottage WM et al (1996) Tissue fixation security in transosseous rotator cuff repairs: A mechanical comparison of simple versus mattress sutures. Arthroscopy 12(6):704–708

    Article  PubMed  CAS  Google Scholar 

  7. Burkhart SS, Nottage WM, Ogilvie-Harris DJ et al (1994) Partial repair of irreparable rotator cuff tears. Arthroscopy 10(4):363–370

    Article  PubMed  CAS  Google Scholar 

  8. Burkhart S, Pagan J, Wirth M, Athanasiou KA (1997) Cyclic loading of anchor-based rotator cuff repairs: Confirmation of the tension overload phenomenon and comparison of suture anchor fixation with transosseous fixation. Arthroscopy 13:720–724

    Article  PubMed  CAS  Google Scholar 

  9. Cummins CA, Appleyard RC, Strickland S, Haen PS, Chen S, Murrell GAC (2005) Rotator cuff repair: An ex vivo analysis of suture anchor repair techniques on initial load to failure. Arthroscopy 21(10):1236–1241

    Article  PubMed  Google Scholar 

  10. Cummins C, Murrell G (2003) Mode of failure for rotator cuff repair with suture anchors identified at revision surgery. J Shoulder Elbow Surg 12:128–133

    Article  PubMed  Google Scholar 

  11. Demirhan M, Atalar AC, Kilicoglu O (2003) Primary fixation strength of rotator cuff repair techniques: a comparative study. Arthroscopy 19(6):572–576

    Article  PubMed  Google Scholar 

  12. Gazielly DF, Gleyze P, Montagnon C (1994) Functional and anatomical results after rotator cuff repair. Clin Orthop 304:43–53

    PubMed  Google Scholar 

  13. Gerber C, Schneeberger AG, Beck M, Schlegel URS (1994) Mechanical strength of repairs of the rotator cuff. J Bone Joint Surg Br 76(3):371–379

    PubMed  CAS  Google Scholar 

  14. Goutallier D, Postel JM, Bergageau J et al (1994) Fatty muscle degeneration in cuff ruptures. Pre- and postoperative evaluation by CT scan. Clin Orthop 304:78–83

    PubMed  Google Scholar 

  15. Harryman DT, Mack LA, Wang KY et al (1991) Repairs of the rotator cuff. Correlation of functional results with integrity of the cuff. J Bone Joint Surg Am 73:982–989

    PubMed  Google Scholar 

  16. Hecker AT, Shea M, Hayhurst JO et al (1993) Pull-out strength of suture anchors for rotator cuff and Bankart lesion repairs. Am J Sports Med 21:874–879

    Article  PubMed  CAS  Google Scholar 

  17. Liu SH, Baker CL (1994) Arthroscopically assisted rotator cuff repair: correlation of functional results with integrity of the cuff. Arthroscopy 10:54–60

    Article  PubMed  CAS  Google Scholar 

  18. Loutzenheiser TD, Harryman DT, Yung SW et al (1995) Optimizing arthroscopic knots. Arthroscopy 11:199–206

    Article  PubMed  CAS  Google Scholar 

  19. Ma BC, Macgillivray JD, Clabeaux J, Lee S, Otis JC (2004) Biomechanical evaluation of arthroscopic rotator cuff stitches. J Bone Joint Surg Am 86(6):1211–1216

    PubMed  Google Scholar 

  20. MacGillivray JD, Ma CB (2004) An arthroscopic stitch for massive rotator cuff tears: The Mac stitch. Arthroscopy 20(6):669–671

    Article  PubMed  Google Scholar 

  21. Mansat P, Cofield RH, Kersten TE, Rowland CM (1997) Complications of rotator cuff repair. Orthop Clin North Am 28:205–213

    Article  PubMed  CAS  Google Scholar 

  22. Mazess RB (1982) On aging bone loss. Clin Orthop 165:239–252

    PubMed  Google Scholar 

  23. Reed SC, Glossop N, Olgivie-Harris DJ (1996) Full-thickness rotator cuff tears: a biomechanical comparison of suture versus bone anchor techniques. Am J Sports Med 24:46–48

    Article  PubMed  CAS  Google Scholar 

  24. Schneeberger AG, Von Roll A, Kalberer F, Hilaire J, Gerber C (2002) Mechanical strength of arthroscopic rotator cuff stitches. J Bone Joint Surg Am 84(12):2152–2160

    PubMed  Google Scholar 

  25. Thal R (2001) A knotless suture anchor: design, function, and biomechanical testing. Am J Sports Med 29(5):646–649

    PubMed  CAS  Google Scholar 

  26. Waltrip RL, Zheng N, Dugas JR, Andrews JR (2003) Rotator cuff repair: a biomechanical comparison of three techniques. Am J Sports Med 31(4):493–497

    PubMed  Google Scholar 

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Acknowledgments

Thanks to the Fischer Owen Orthopaedic Research Fund for sponsoring this project and to Dr. Michael Voor for his technical guidance and support.

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Correspondence to John Nyland.

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Ammon, J.T., Nyland, J., Chang, H.C. et al. Evaluation of BioCorkscrew and Bioknotless RC suture anchor rotator cuff repair fixation: an in vitro biomechanical study. Knee Surg Sports Traumatol Arthr 15, 1375–1381 (2007). https://doi.org/10.1007/s00167-007-0321-0

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  • DOI: https://doi.org/10.1007/s00167-007-0321-0

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