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At least 19 recordsLinked to original sources

PubMed1997

Technique of arthroscopic rotator cuff repair using implantable 4-mm Revo suture anchors, suture Shuttle Relays, and no. 2 nonabsorbable mattress sutures.

This article reviews an arthroscopic technique used to repair small- and medium-sized rotator cuff tears using a retrievable screw-in suture anchor and permanent braided sutures. The cuff is shaved, the bone is prepared arthroscopically, and a subacromial decompression is performed. After implanting the anchors, the sutures are passed through the cuff using Shuttle Relay suture passers and a suture punch. To complete the repair, the sutures are tied using a knot-pusher.

Arthroscopes↗

PubMed1995

The ultimate strength of suture anchors.

Suture anchors of various designs are gaining acceptance for open and arthroscopic procedures. The rapid proliferation of these devices challenges those using them to apply objective criteria for device selection. Comparative data on implant security in different settings, modes of failure, and ultimate failure strengths is lacking. This study was undertaken to independently develop such data for an objective comparison of the suture anchors currently available. Using a fresh never-frozen porcine femur model, 10 samples of each of the 14 different anchors tested were inserted into each of the three different test areas; diaphyseal cortex (usually 3- to 4-mm thick), metaphyseal cortex (usually 1- to 2-mm thick), and a cancellous bone "trough". The suture anchors were threaded with 0.018-inch stainless steel wire or, for anchors requiring a more flexible suture, 0.018-inch stainless steel 1 x 7 wire braid. Tensile stress parallel to the axis of insertion was applied at a rate of 12.5 mm/second by an Instron 1321 (Instron Corp, City, State) until failure. Average failure strength was calculated for each anchor at each test area. The anchors tested were the Mitek G2, Mitek G3, Mitek G4 (Mitek Surgical Products, Norwood, MA), Linvatec Revo screw (Linvatec, Largo, FL), Acufex TAG Wedge, Acufex TAG Rod 2 (Acufex Microsurgical, Mansfield, MA), Statak models 1.5, 2.5, 3.5, 5.0, and 5.2 (Zimmer, Warsaw, IN), Arthrex ESP (Arthrex Inc., Naples, FL), Arthrotek Harpoon, and Arthrotek LactoSorb (Arthrotek, Warsaw, IN). The average failure strength of each of these anchors in the diaphyseal cortex, metaphyseal cortex, and cancellous bone is reported.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed2001

Biomechanical analysis of suture anchors and suture materials used for toggle pin stabilization of hip joint luxation in dogs.

OBJECTIVE: To compare in vitro mechanical properties of toggle pins and toggle rods used as suture anchors and of 3 suture materials (50-lb monofilament polybutester, No. 5 braided polyester, and 5-mm woven polyester) commonly used as prosthetic ligaments in the repair of hip joint luxation in dogs. SAMPLE POPULATION: Femoropelvic specimens from the cadavers of 18 dogs. PROCEDURE: Suture anchors were compared by use of pullout tests. Suture materials were compared by use of monotonic and cyclic tensile tests; cyclic tensile tests were performed with the suture placed over the edge of an aluminum bar to simulate the edge of the femoral bone tunnel. In vitro mechanical properties of the ligament of the femoral head were determined by use of monotonic tensile tests, using bone-ligament-bone cadaveric specimens. The in vitro mechanical properties of the acetabulum-ligament-femur complex and of this complex following rupture of the ligament and stabilization with a toggle rod and 5-mm woven polyester were determined by use of compression tests that simulated weight-bearing. RESULTS: Mechanical properties of the toggle rod were not significantly different from those of the toggle pin. Woven polyester had the longest fatigue life in cyclic testing. Hip joints stabilized with a toggle rod and woven polyester had less than half the strength in vitro of intact joints. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that a toggle rod or toggle pin can be used for stabilization of hip joint luxations in dogs. Of the materials tested, braided polyester had the best in vitro mechanical properties.

Animals↗

PubMed2005

Biomechanical comparison of bioabsorbable sutureless screw anchor versus suture anchor fixation for rotator cuff repair.

PURPOSE: Anchors that directly fix the rotator cuff to bone without using sutures may simplify the challenges associated with arthroscopic rotator cuff repair. This study compared a bioabsorbable screw fixation device to a standard suture anchor fixation method. TYPE OF STUDY: Randomized trial. METHODS: A poly-L-lactide acid (PLLA), bioabsorbable screw anchor was compared with a metallic suture anchor loaded with No. 2 braided polyester suture in 12-week-old fresh-frozen bovine shoulders. Twelve specimens were randomly assigned to the 2 repair groups (6 per group). A 1 x 2-cm defect was created at the insertion site of the infraspinatus tendon. Two anchors were implanted 1 cm apart in the anatomic insertional area of the infraspinatus tendon. After preconditioning to 10 N, each construct was cycled between 10 and 180 N for up to a maximum of 2,500 cycles at a rate of 33 mm/second using a materials testing machine. The number of cycles to 5- and 10-mm gap formation at the repair site and mode of failure were recorded. Clinically, 10-mm gap formation defines complete fixation failure. Data were evaluated using an analysis of variance with significance set at P < .05. RESULTS: Mattress suture fixation had significantly higher number of cycles to 10-mm failure compared with the PLLA device (P = .015). Failure occurred by tissue pullout in half the specimens and by device failure in the other half, without differences in failure modalities between groups. CONCLUSIONS: This anchor provides low-profile fixation of the rotator cuff and eliminates suture placement and knot tying during arthroscopic and mini-open cuff repair. However, these data suggest that this anchor may not perform adequately under cyclic loading conditions in patients during postoperative rehabilitation. CLINICAL RELEVANCE: This bioabsorbable anchor may not provide sufficient fixation for rotator cuff repair in humans.

Absorbable Implants↗

PubMed2005

A radiographic investigation to determine the safety of suture anchor systems for pediatric modified Broström ankle ligament reconstruction.

BACKGROUND: The modified Broström ligament reconstruction using anchor sutures has been performed in adults with clinical success; however, the safety parameters for the use of suture anchors in adolescent lateral ankle ligament reconstruction have not been established. PURPOSE: To perform a radiographic analysis comparing the depth of penetration of suture anchors in adult ankle ligament reconstruction with the average distance of the physis from the tip of the fibula in adolescents. STUDY DESIGN: Cross-sectional study, Level of evidence, 4. METHODS: Forty postoperative ankle radiographs of adult patients who had a modified Broström procedure were compared with 40 normal adolescent ankle radiographs. In the adult group, the distance of the suture anchor penetration from the distal tip of the fibula was measured; in the adolescent group, the distance of the physis from the distal tip of the fibula was measured. RESULTS: The mean depth of the suture anchors was 17 mm (range, 14-21 mm) from the tip of the fibula in the adult group, and the mean distance of the growth plate was 23 mm (range, 18-29 mm) in the adolescent group. Eight radiographs from the adolescent group (20%) had a physis measurement of <22 mm on the anteroposterior or mortise view. CONCLUSIONS: Using careful preoperative planning and intraoperative technique, it is possible to safely perform lateral ankle ligament repair in the skeletally immature patient using suture anchors.

Adolescent↗

PubMedDate not supplied

Fatigue testing of suture anchors.

In a porcine tibia model, we subjected widely used anchor-suture combinations to a fatigue-testing protocol. The Ethibond No. 2 suture was the weakest part of the anchor-suture combinations when they were loaded to failure by a single pull. Under cyclic-loading conditions, fixation strength was decreased compared with single-pull tests. The suture/anchor interface was identified as the weakest link in the Mitek GII/No. 2 combination and in the Zimmer Statak 3.5/No. 2 combination. In most cases the suture was worn through at the eyelet. Threading the GII anchor with a No. 5 suture and use of larger anchors in combination with No. 2 sutures increased the fatigue strength. Suture breakage at the knot was the predominant failure mode for biodegradable anchors inserted into cortical bone. The highest fatigue strength was seen for the Super Anchor/No. 5 combination when the anchor was inserted in cortical bone. Fatigue testing is crucial for evaluation of suture anchors and should be performed along with single-pull testing. The mechanical performance of a suture anchor threaded with a defined suture depends on several key factors: the pullout strength of the anchor, the tensile strength of the suture, and the interaction of anchor and suture at the eyelet (suture/anchor interface).

Animals↗

PubMed2007

Stress distribution in the supraspinatus tendon after tendon repair: suture anchors versus transosseous suture fixation.

BACKGROUND: The stress concentration at the site of supraspinatus tendon repair, either by suture anchor fixation or by transosseous suture fixation, has not been fully clarified. HYPOTHESIS: Suture anchor fixation showed higher stress concentrations in the tendon than did transosseous suture fixation. STUDY DESIGN: Controlled laboratory study. METHODS: Three finite element models were developed based on a previously published model of normal supraspinatus tendon (0 degrees abduction). Single-row fixation, double-row fixation, and transosseous suture fixation were simulated. A tensile force was applied to the proximal end of the supraspinatus tendon to simulate its contraction force. RESULTS: In the single-row model, the stress appeared from the site of the anchor and extended into the proximal tendon. The highest stress concentration was observed on the bursal surface of the tendon. The double-row model showed a similar pattern to the single-row model except that the stress concentration was observed only around the medial anchor. In the transosseous model, the stress appeared from the attachment site to a bony trough, which extended proximally into the tendon substance. No significant stress concentration was observed inside the tendon. CONCLUSION: Both single-row and double-row fixations showed higher stress concentration inside the tendon than did transosseous suture fixation. CLINICAL RELEVANCE: A high stress concentration might be a cause of the rerupture often observed after arthroscopic cuff repair using suture anchors.

Adaptation, Physiological↗

PubMed2005

Pullout strength of knotless suture anchors.

PURPOSE: Suture anchors are used consistently for repairs of soft tissues, especially around the glenohumeral joint. These anchors can be used either arthroscopically or in an open procedure to anatomically restore the labrum and capsular tissues to the glenoid after avulsion injuries (Bankart lesion). The purpose of this study was to analyze the pullout strength of a new knotless suture anchor (Mitek Knotless Suture Anchor; Mitek, Norwood, MA) compared with 2 commercially available suture anchors that require knots to be tied (Mitek Panalok 3.5-mm Anchor and Mitek GII Quick Anchor). TYPE OF STUDY: Randomized cadaveric study. METHODS: Three groups of 10 anchors were tested on 15 fresh-frozen cadaveric glenoids. Two anchors were affixed to the anterior glenoid in subchondral bone, 1 each from 2 groups. In this way, the variance of bone density among groups was minimized. The anchors requiring knots were fixed to the glenoid and tied to a ring using a Duncan knot with 3 half-hitches alternating posts. The Knotless Anchor was looped through the ring and anchored into the glenoid as described by the manufacturer. All constructs were then tested for tensile strength on an Instron machine (Canton, MA) using a crosshead speed of 200 mm/min. Ultimate failure was defined as complete failure of the construct (either suture breakage or anchor pullout). Data were then analyzed for statistical significance using analysis of variance analysis among the 3 groups, and a 2-tailed t test for statistical significance among groups. RESULTS: The average failure under tensile load for the GII, Panalok, and Knotless Anchors were 471.5 N, 432.8 N, and 650.0 N, respectively. Statistical analysis showed a statistical difference between the Knotless Anchor and the GII and Panalok sutures ( P = .02). Two-tailed t tests between the Knotless Anchor and the GII or Panalok Anchors were also significant (P = .02 and P = .02, respectively). Observations included a large standard deviation within groups. This is thought to result from the variation in bone density because markedly lower tensile loads were recorded for those anchors that pulled out from the bone before suture failure. CONCLUSIONS: The Knotless Suture Anchor is a statistically stronger construct with respect to tensile loads. It appears to be a viable option for any type of soft-tissue repair around the glenoid. CLINICAL RELEVANCE: Because the knot in suture repair is consistently the weakest point in the construct and because of the difficulty in tying knots arthroscopically, the Knotless Suture Anchor appears to be a stronger and easier method for both arthroscopic and open Bankart repair, with or without capsular shift.

Cadaver↗

PubMed2003

[Reinsertion of the flexor tendon using a suture anchor: prospective study using early active motion].

INTRODUCTION: The aim of this study was to evaluate subjective and functional results of a prospective continuous series of immediate tendon-to-bone repair of the F.D.L. using a miniaturized anchor. METHOD: Seven patients have been operated by the same surgeon in emergency for a section of the FDL in zone one. Distal tendon-to-bone re-attachment has been realized using a mini-G II Mitek anchor suture. Five of the patient were male, four of them being manual workers. Only one had a work accident. According to Leddy and Packer's classification one patient had a stage 1 lesion and the six others had stage two lesions. The injured fingers showed associated lesions in four cases. Rehabilitation consisted of early active mobilization protected by a Duran-type splint. All the patients had been examined by an independent surgeon at 10 months follow-up. Mean age at that time was 32 years. RESULTS: One patient was very satisfied with his results while the six others were satisfied. Two minor complications were encountered, one of them being directly in relation to the implant. Total Active Motion (TAM) summed up to 92% of the arch of motion of the normal controlateral finger. Pinch-force reached 81% compared to that of the controlateral finger. Two patients described no pain. Mean eviction from work was 70 days. DISCUSSION: Tendon-to-bone repair of the FDL using an anchor seems to give good results on pain, TAM and on force. The only complication due to the implant did not have any functional incidence. The series of Marin Braun on 77 cases of such repairs using a barb-wire show similar results compared to the implant used in our series. However, anchor sutures have several advantages compared to a transcutaneous device: they reduce the risk of infection, of nail dystrophy and they offer a better comfort to the patient.

Adolescent↗

PubMed2006

Bone cement improves suture anchor fixation.

Suture anchor fixation failure can occur if the anchor pulls out of bone. We hypothesized that suture anchor fixation can be augmented with polymethylmethacrylate cement, and that polymethylmethacrylate can be used to improve fixation in a stripped anchor hole. Six matched cadaveric proximal humeri were used. On one side, suture anchors were placed and loaded to failure using a ramped cyclic loading protocol. The stripped anchor holes then were injected with approximately 1 cc polymethylmethacrylate, and anchors were replaced and tested again. In the contralateral humerus, polymethylmethacrylate was injected into anchor holes before anchor placement and testing. In unstripped anchors, polymethylmethacrylate increased the number of cycles to failure by 34% and failure load by 71% compared with anchors not augmented with polymethylmethacrylate. Polymethylmethacrylate haugmentation of stripped anchors increased the cycles to failure by 31% and failure load by 111% compared with unstripped uncemented anchors. No difference was found in cycles to failure or failure load between cemented stripped anchors and cemented unstripped anchors. Polymethylmethacrylate can be used to augment fixation, reducing the risk of anchor pull-out failure, regardless whether the suture anchor hole is stripped or unstripped.

Aged↗

PubMed2006

The suture-weave technique: a method of reloading a deployed unloaded suture anchor.

Many suture anchors hold 2 sutures per anchor. Occasionally during a procedure, 1 of these sutures may be inadvertently pulled out of the anchor eyelet. We describe the technique of rethreading a deployed suture anchor in the event that 1 of the sutures is inadvertently unloaded from the anchor eyelet. We have evaluated its effectiveness in vivo. The basic steps of the "suture-weave" technique are as follows. If 1 strand remains threaded through the anchor eyelet, it is tensioned so that there is 1 long end and 1 short end. The free suture is threaded into the eye of a graft preparation needle and this needle is then used to pierce the braids of the long end of the threaded suture. The free suture is interwoven through the braids of the threaded suture. The short end of the threaded suture is then pulled while visualizing the anchor eyelet arthroscopically. The free suture passes through the eyelet as the intersection of the 2 woven sutures traverses the eyelet. During this process, 3 suture strands are traversing the eyelet. Finally, the intersecting suture limbs are pulled free from each other such that there are 2 separate suture strands that slide independently and pass through the anchor eyelet once again. This procedure has been successfully used in vivo without complications. It is important to note that this procedure will only work in an anchor eyelet that will allow for the passage of 3 suture strands.

Arthroscopy↗

PubMed2005

Rotator cuff repair: an ex vivo analysis of suture anchor repair techniques on initial load to failure.

PURPOSE: To determine the best combination of anchors and suture techniques for repairing torn rotator cuff tendons. TYPE OF STUDY: Ex vivo biomechanical investigation. METHODS: Sixty fresh-frozen sheep infraspinatus tendons were repaired using 6 different repair techniques: transosseous sutures with 2 sutures and mattress stitches; 2 suture anchors with 1 suture per anchor using either simple stitches, mattress stitches, or modified Kessler stitches; 2 suture anchors with 2 sutures per anchor using simple stitches; or 5 suture anchors with 1 suture per anchor and a mattress stitch pattern. RESULTS: No difference was identified between transosseous sutures (mean +/- SD, 147 +/- 68 N) and suture anchors (140 +/- 36 N) when 2 mattress stitches were used. The weakest construct with suture anchors was when the tendon was grasped with 2 suture anchors with 1 suture per anchor and a simple stitch pattern (72 +/- 25 N). Repair strength increased 2-fold with 2 suture anchors single loaded and a mattress stitch configuration (140 +/- 36 N; P = .026), 3-fold with 2 suture anchors single loaded and a modified Kessler stitch pattern (204 +/- 32 N; P < .001), and 3-fold with 2 suture anchors double loaded and a simple stitch suture pattern (212 +/- 39 N; P < .001). The highest tensile load was observed with 5 suture anchors in a double-row configuration, single loaded, that grasped the tendon with mattress stitches (336 +/- 59 N; P < .001). CONCLUSIONS: This study shows that in an ovine model, initial rotator cuff repair strength can be enhanced by increasing the number of suture anchors used in the repair and by using anchors that are double loaded with suture and suture configurations that pass more frequently through the tendon. CLINICAL RELEVANCE: The clinical relevance of this ex vivo investigation is that the initial load to failure of a rotator cuff repair may be increased by increasing the number of suture anchors, the number of sutures per anchor, or using suture patterns that grab more adjacent tendon fibers.

Animals↗

PubMed2003

The effect of suture anchor design and orientation on suture abrasion: An in vitro study.

PURPOSE: To evaluate the effects of suture anchor design and orientation on suture abrasion in a cyclic model. TYPE OF STUDY: In vitro. METHODS: Biomechanical studies have shown suture breakage to be a predominant mode of failure in a suture anchor repair construct. It is possible that suture abrasion during knot tying or in vivo cyclic loading may contribute to early failure. This study specifically investigates suture abrasion caused by 17 commonly used suture anchors and demonstrates the effects of suture anchor angulation and rotation on suture abrasion. To eliminate target tissue as a source of failure, all anchors were implanted into a solid block of sawbones material and tested with No. 2 Ethibond Excel sutures (Ethicon, Somerville, NJ). The testing model focused on 3 variables: suture anchor type, suture pull angle (SA) and angle of anchor rotation (RA). Abrasion testing was then performed on a servohydraulic materials testing system by continually cycling the suture back and forth through each anchor with an excursion of 4 cm at a rate of 0.5 Hz under a load of 10 N until suture failure occurred. RESULTS: Sutures performed significantly better when cycled in line with the anchor at 0 degrees SA with 0 degrees RA than they did at 45 degrees SA with 0 degrees RA or 45 degrees SA with 90 degrees RA. We found no significant difference between anchors tested at 45 degrees SA with 0 degrees RA and 45 degrees SA with 90 degrees RA. For tests performed using metallic suture anchors, all constructs failed by fraying of the suture. Constructs using biopolymer anchors and nonabsorbable polymeric anchors experienced a mixture of suture and anchor eyelet failures. CONCLUSIONS: In addition to the statistically significant detrimental effects of suture anchor angulation and rotation on suture abrasion, suture anchor eyelet design may also influence suture abrasion. Surgeons should be aware of the effects of anchor angulation, suture position in the eyelet, and design and composition of the eyelet to maximize the durability of the construct.

Biopolymers↗

PubMed2001

Cyclic loading of rotator cuff repairs: A comparison of bioabsorbable tacks with metal suture anchors and transosseous sutures.

PURPOSE: The purposes of the study were (1) to compare rotator cuff repair strengths after cyclic loading of 2 bioabsorbable nonsuture-based tack-type anchors, transosseous sutures, and a metal suture-based anchor, and (2) to correlate bone mineral density with mode of failure and cycles to failure. We hypothesized that specimens with a lower bone density would fail through bone at a lower number of cycles independent of the method of cuff fixation. TYPE OF STUDY: Ex vivo biomechanical study. METHODS: Standardized full-thickness rotator cuff defects were created in 30 fresh-frozen cadaveric shoulders that were randomized to 1 of 4 repair groups: transosseous sutures; Mitek Super suture anchors (Mitek Surgical Products, Westwood, MA); smooth bioabsorbable 8-mm Suretacs (Acufex, Smith & Nephew Endoscopy, Mansfield, MA); or spiked bioabsorbable 8-mm Suretacs (Acufex). All repairs were cyclically loaded from 10 to 180 N; the numbers of cycles to 50% (gap, 5 mm) and 100% (gap, 10 mm) failure were recorded. RESULTS: In comparing the repair groups, we found only 1 significant difference: the number of cycles to 100% failure was significantly higher (P <.05) for the smooth bioabsorbable tack than for the transosseous suture group. There were no statistically significant (P </=.05) differences in bone mineral densities with regard to each specimen's mode of failure. CONCLUSIONS: Our results suggested that immediate postoperative fixation provided by bioabsorbable tacks was similar to that provided by Mitek anchors and more stable than that provided by transosseous sutures. Therefore, the immediate postoperative biomechanical strength of bioabsorbable tacks seems comparatively adequate for fixation of selected small rotator cuff tears. However, additional evaluation in an animal model to examine degradation characteristics and sustained strength of repair is recommended before clinical use.

Absorbable Implants↗

PubMed2004

Modified technique for arthroscopic Bankart repair using anchor sutures.

Bankart repair, or one of its modifications, is currently the gold standard procedure for treatment of anterior traumatic shoulder instability. It is now possible to perform the operation arthroscopically with the introduction of suture anchors. As described by Eugene Wolf, arthroscopic shoulder stabilization using the Mitek (Mitek Surgical Products, Ethicon, Edinburgh, U.K.) anchors requires two anterior portals and intra-articular knot tying. However, sliding the anchor on the inside limb of a suture loop could be challenging because the other limb could get tangled in the nitinol arc of the anchor. We describe a modification of the original technique to prevent that possibility and avoid any tension on the repair tissue during anchor passage. The proposed modification involves the use of a cheap, readily available silastic feeding tube to isolate the outside limb of the suture loop and stabilize labral tissues while the anchor is being passed. This tube also serves as a stent for knot tying. By allowing the whole operation to be performed through one anterior portal, the modified technique reduces possible morbidity associated with a second portal and further reduces cost.

Arthroscopy↗

PubMed2006

Suture anchors are superior to transglenoid sutures in arthroscopic shoulder stabilization.

PURPOSE: We retrospectively compared 2 groups of high-demand patients with post-traumatic anterior shoulder instability to determine whether arthroscopic stabilization was superior with transglenoid suture or suture anchors. METHODS: In a retrospective comparative study we investigated the results of 246 high-demand patients, with post-traumatic anterior shoulder instability, who underwent arthroscopic capsulolabral reconstruction: 165 (mean age, 27.5 years; mean follow-up, 80 months) were evaluated after treatment with transglenoid sutures, and 81 (mean age, 26.6 years; mean follow-up, 27 months) were treated with suture anchors in a consecutive period. We compared both techniques with regard to recurrence rate, postoperative complications, range of motion, sport activity, work, and patient satisfaction. RESULTS: In the anchor group recurrent dislocation after surgery occurred in 7 patients (8.7%), all within 18 months postoperatively. This finding was significantly (P = .009) better than that in the transglenoid group, in which recurrent postoperative dislocation occurred in 57 patients (34%), in a period of 0 to 115 months after surgery. Postoperative complications were seen in 4 of 81 patients in the suture anchor group, whereas a significantly (P = .01) higher rate was found in the transglenoid suture group, with 36 complications in 35 of 165 patients. CONCLUSIONS: The data presented in this study suggest that the modern suture anchor technique results in a better outcome after shoulder stabilization, with fewer complications and lower recurrence rates, than the transglenoid repair. We conclude that the suture anchor technique should be a preferred method for arthroscopic shoulder stabilization surgery. LEVEL OF EVIDENCE: Level III, retrospective, comparative therapeutic study.

Adolescent↗

PubMed1996

Use of the T-fix suture anchor in fascial sheath reconstruction of complex meniscal tears.

The importance of preserving meniscal tissue has become increasingly apparent as studies have demonstrated early arthritic changes in the knee. To increase the healing rate of complex tears, the use of a fascial sheath to encapsulate the exogenous clot around the tear has previously been proposed. This report describes the placement of a fascial sheath over a repaired meniscal tear using a T-fix anchor suture. With the increased use of fascial sheaths in combination with an exogenous blood clot, meniscal repair rates in complex tears can be increased.

Arthroscopy↗

PubMedDate not supplied

Fixation strength of rotator cuff repairs with suture anchors and the transosseous suture technique.

The strength of classic transosseous suture repair of rotator cuff tendons was compared with similar repairs with four "third-generation" suture anchors. Results demonstrate the repair construct selected had a significant influence on failure at ultimate load (p = 0.005). Among the anchors tested the Statak design was significantly stronger than the other three. Furthermore Statak, Harpoon, and Superanchor designs were all significantly stronger than the Revo screw. No significant difference was seen between the strength of repairs performed with the Statak, the Harpoon, or the Superanchor compared with the transosseous suture technique. The transosseous suture technique was significantly stronger than repairs performed with the Revo. We conclude suture anchor design has evolved to a point where initial fixation of torn rotator cuff tendons is equivalent to more traditional techniques using only sutures.

Aged↗