Levent Horoz1, Onur Hapa2, F Alan Barber3, Buğra Hüsemoğlu4, Mustafa Özkan1, Hasan Havitçioğlu1. 1. Department of Orthopedic Surgery, Dokuz Eylül University, Izmir, Turkey. 2. Department of Orthopedic Surgery, Dokuz Eylül University, Izmir, Turkey. Electronic address: onurhapa@gmail.com. 3. Plano Orthopedic and Sports Medicine Center, Plano, Texas, U.S.A. 4. Department of Biomechanics, Dokuz Eylül University, Izmir, Turkey.
Abstract
PURPOSE: To evaluate the load to failure strength of anchor techniques suitable for osteoporotic bone. METHODS: Using an osteoporotic ovine model in 72 humeri, 6 fixation techniques were tested. Group 1: two interlocking 5-mm anchors with fewer, wider threads; group 2: one 5-mm anchor; group 3: one 5-mm anchor reinforced laterally by a 6.5-mm cancellous screw; group 4: one 5-mm anchor in an area reinforced with a cancellous plug; group 5: two interlocking 5-mm anchors with smaller threads; group 6: one 5-mm smaller threaded anchor. After a 10-N preload, the specimens were cyclically loaded between 10 N and 30 N for 50 cycles and then destructively tested. Peak-to-peak displacement, cyclic elongation, ultimate load, stiffness, and failure mode were recorded. RESULTS: Group 1 had lower peak-to-peak displacement than group 3 (P = .001), group 5 (P = .001), and group 6 (P = .033). In addition, group 1 showed lower cyclic elongation than group 3 (P = .001), group 5 (P = .035), and group 6 (P = .001). Group 1 had a higher ultimate load than group 2 (P = .002), group 3 (P = .019), and group 6 (P = .006). Group 1 also showed higher stiffness than group 2 (P = .007) and group 3 (P = .022). Mode of failure was predominantly caused by anchor pullout for all of the groups except group 3, which mainly failed by suture rupture. CONCLUSIONS: Two interlocking suture anchors are stronger than a single anchor in osteoporotic bone. The anchor with fewer, wider threads and a smaller core diameter showed greater strength and less elongation than the other constructs. Reinforcement by cancellous autografting increased suture anchor strength. CLINICAL RELEVANCE: Considering concerns about suture anchor pullout from osteoporotic bone, interlocking a second suture anchor with the first increases load to failure resistance. Anchors with small core diameters and fewer but wider threads are more efficient in osteoporotic bone.
PURPOSE: To evaluate the load to failure strength of anchor techniques suitable for osteoporotic bone. METHODS: Using an osteoporotic ovine model in 72 humeri, 6 fixation techniques were tested. Group 1: two interlocking 5-mm anchors with fewer, wider threads; group 2: one 5-mm anchor; group 3: one 5-mm anchor reinforced laterally by a 6.5-mm cancellous screw; group 4: one 5-mm anchor in an area reinforced with a cancellous plug; group 5: two interlocking 5-mm anchors with smaller threads; group 6: one 5-mm smaller threaded anchor. After a 10-N preload, the specimens were cyclically loaded between 10 N and 30 N for 50 cycles and then destructively tested. Peak-to-peak displacement, cyclic elongation, ultimate load, stiffness, and failure mode were recorded. RESULTS: Group 1 had lower peak-to-peak displacement than group 3 (P = .001), group 5 (P = .001), and group 6 (P = .033). In addition, group 1 showed lower cyclic elongation than group 3 (P = .001), group 5 (P = .035), and group 6 (P = .001). Group 1 had a higher ultimate load than group 2 (P = .002), group 3 (P = .019), and group 6 (P = .006). Group 1 also showed higher stiffness than group 2 (P = .007) and group 3 (P = .022). Mode of failure was predominantly caused by anchor pullout for all of the groups except group 3, which mainly failed by suture rupture. CONCLUSIONS: Two interlocking suture anchors are stronger than a single anchor in osteoporotic bone. The anchor with fewer, wider threads and a smaller core diameter showed greater strength and less elongation than the other constructs. Reinforcement by cancellous autografting increased suture anchor strength. CLINICAL RELEVANCE: Considering concerns about suture anchor pullout from osteoporotic bone, interlocking a second suture anchor with the first increases load to failure resistance. Anchors with small core diameters and fewer but wider threads are more efficient in osteoporotic bone.
Authors: Lara Locatelli; Cesar A Q Martins; Arthur P G Santos; Patricia O Cubillos; Carlos R M Roesler Journal: Arthrosc Sports Med Rehabil Date: 2021-02-01
Authors: Jakob E Schanda; Barbara Obermayer-Pietsch; Gerhard Sommer; Philipp R Heuberer; Brenda Laky; Christian Muschitz; Klaus Pastl; Eva Pastl; Christian Fialka; Rainer Mittermayr; Johannes Grillari; Ines Foessl Journal: BMC Musculoskelet Disord Date: 2022-05-05 Impact factor: 2.562