Biomechanical Analysis of Anteroinferior Bankart Repair Anchor Types.

Autor:	Yanke AB; Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois, USA., Allahabadi S; Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois, USA., Wang Z; Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois, USA., Credille KT; Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois, USA., Shewman E; Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois, USA., Bonadiman JA; Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois, USA., Elias TJ; Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois, USA., Hevesi M; Mayo Clinic, Rochester, Minnesota, USA., Garrigues GE; Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois, USA., Verma NN; Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois, USA.
Jazyk:	angličtina
Zdroj:	The American journal of sports medicine [Am J Sports Med] 2023 Aug; Vol. 51 (10), pp. 2642-2649. Date of Electronic Publication: 2023 Jun 21.
DOI:	10.1177/03635465231180621
Abstrakt:	Background: All-suture anchors and knotless anchors are increasingly used in the repair of anteroinferior labral tears in patients with shoulder instability. Optimal repair constructs may limit recurrent instability. Purpose: To perform a quantitative biomechanical comparison of 3 labral fixation devices for soft tissue Bankart lesions: knotless soft-body tensionable anchor (SB knotless), knotted soft-body anchor (SB knotted), and knotless hard-body PEEK (polyether ether ketone) interference anchor (HB knotless). Study Design: Controlled laboratory study. Methods: A total of 21 glenoid specimens were randomized into 3 groups: SB knotless, SB knotted, and HB knotless. Artificial Bankart lesions were created at the anteroinferior labrum. Anchors were placed at the 3:30, 4:30, and 5:30 clockface positions, and sutures were passed through 1 cm of tissue. Anchors were tested simultaneously as one construct by pulling capsular tissue connected to the anteroinferior quadrant. Cyclic loading (5-25 N, 100 cycles) was followed by load-to-failure testing (15 mm/min). Biomechanical testing variables were collected, and failure mechanisms were recorded per individual anchor. Results: There were no differences in baseline specimen characteristics. There was no difference in elongation during cyclic loading ( P = .40). The ultimate load to failure between SB knotless (309.7 ± 125.6 N), SB knotted (226.4 ± 34.8 N), and HB knotless (256.5 ± 90.5 N) did not significantly differ ( P = .25). Failure mechanisms differed among groups ( P = .008); mechanisms included anchor pullout (SB knotless: 33.3%; SB knotted: 23.8%; HB knotless: 28.6%), suture pull-through (SB knotless: 66.7%; SB knotted: 38.1%; HB knotless: 33.3%), and anchor fixation method failure, defined as knot failure for knotted anchors or locking mechanism failure for knotless anchors (SB knotless: 0.0%; SB knotted: 38.1%; HB knotless: 38.1%).). Conclusion: The SB knotless, SB knotted, and HB knotless labral fixation anchors studied exhibited comparable elongation during cyclic loading, stiffness, and ultimate loads to failure in a cadaveric model. However, the failure mechanisms significantly differed, as SB knotless anchors failed primarily from suture pull-through, while SB knotted and HB knotless anchors were subject to knot failure and locking mechanism failure, respectively. Clinical Relevance: These data support the benefit of SB knotless anchors for anteroinferior labral repair in limiting knot failure typically seen with knotted anchors, perhaps demonstrating that all-suture anchors may have better locking mechanism quality than their PEEK counterparts.
Databáze:	MEDLINE
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