TY - JOUR
T1 - Biomechanical evaluation of different suture anchors for the stabilization of anterior labrum lesions
AU - Mueller, Michael B.
AU - Fredrich, Helmut H.
AU - Steinhauser, Erwin
AU - Schreiber, Ulrich
AU - Arians, Achim
AU - Imhoff, Andreas B.
PY - 2005/5
Y1 - 2005/5
N2 - Purpose: The aim of the study was to investigate the biomechanical performance of different devices for anterior shoulder reconstruction in a clinically relevant human cadaver shoulder model. Type of study: Biomechanical cadaveric study. Methods: The soft tissue, except for the joint capsule, was dissected from 28 fresh-frozen human shoulder specimens. A Bankart lesion was created and repaired with 3 suture anchors. The devices tested were the 2.4-mm Fastak (Arthrex, Karlsfeld, Germany) with either Ethibond (Ethicon, Westwood, MA) no. 2 or 3, the 2.8-mm Fastak with Ethibond no. 2, the Panalok (Mitek, Norwood, MA) with Ethibond no. 2 with a modified setting technique, and the 8-mm Suretac (Acufex Microsurgical, Mansfield, MA). The specimens were anteriorly dislocated in 60° glenohumeral abduction and 90° external rotation. Load was measured continuously and failures were noted. The experimental groups were compared with each other and with a control group with intact shoulders. Results: Bankart repair with 2.4-mm Fastaks and Ethibond no. 2 and 3 failed at a mean load of 342.0 N and 692.2 N, respectively, predominantly by suture rupture at the eyelet of the anchor. Shoulder reconstruction with 2.8-mm Fastaks failed at an average load of 722.8 N, mostly by suture rupture at the knot. The difference to the 2.4-mm Fastak with Ethibond no. 2 was significant (P < .05). The mean load to failure was 983.8 N in the Panalok group, and the most frequent failure mode was suture rupture at the knot. Bankart repair with Suretac failed at an average load of 468.4 N, typically by capsular damage at the repair site. Capsular injuries in the control group occurred at a mean load of 958.2 N. Anterior shoulder reconstruction with 2.4-mm Fastak with Ethibond no. 2 and with Suretac were statistically significantly inferior to the control group (P < .05). Conclusions: All tested devices allow stable anterior shoulder reconstruction, but we recommend the Panalok and the 2.8-mm Fastak because they provided greater stability than either the 2.4-mm Fastak or the Suretac in our experiments. Suretac can possibly cause additional capsular damage in redislocations after Bankart repair. Clinical relevance: This cadaveric study gives an insight into the biomechanical performance of a Bankart repair with different devices directly postoperative and shows possible failure modes and additional injuries in case of early traumatic redislocation.
AB - Purpose: The aim of the study was to investigate the biomechanical performance of different devices for anterior shoulder reconstruction in a clinically relevant human cadaver shoulder model. Type of study: Biomechanical cadaveric study. Methods: The soft tissue, except for the joint capsule, was dissected from 28 fresh-frozen human shoulder specimens. A Bankart lesion was created and repaired with 3 suture anchors. The devices tested were the 2.4-mm Fastak (Arthrex, Karlsfeld, Germany) with either Ethibond (Ethicon, Westwood, MA) no. 2 or 3, the 2.8-mm Fastak with Ethibond no. 2, the Panalok (Mitek, Norwood, MA) with Ethibond no. 2 with a modified setting technique, and the 8-mm Suretac (Acufex Microsurgical, Mansfield, MA). The specimens were anteriorly dislocated in 60° glenohumeral abduction and 90° external rotation. Load was measured continuously and failures were noted. The experimental groups were compared with each other and with a control group with intact shoulders. Results: Bankart repair with 2.4-mm Fastaks and Ethibond no. 2 and 3 failed at a mean load of 342.0 N and 692.2 N, respectively, predominantly by suture rupture at the eyelet of the anchor. Shoulder reconstruction with 2.8-mm Fastaks failed at an average load of 722.8 N, mostly by suture rupture at the knot. The difference to the 2.4-mm Fastak with Ethibond no. 2 was significant (P < .05). The mean load to failure was 983.8 N in the Panalok group, and the most frequent failure mode was suture rupture at the knot. Bankart repair with Suretac failed at an average load of 468.4 N, typically by capsular damage at the repair site. Capsular injuries in the control group occurred at a mean load of 958.2 N. Anterior shoulder reconstruction with 2.4-mm Fastak with Ethibond no. 2 and with Suretac were statistically significantly inferior to the control group (P < .05). Conclusions: All tested devices allow stable anterior shoulder reconstruction, but we recommend the Panalok and the 2.8-mm Fastak because they provided greater stability than either the 2.4-mm Fastak or the Suretac in our experiments. Suretac can possibly cause additional capsular damage in redislocations after Bankart repair. Clinical relevance: This cadaveric study gives an insight into the biomechanical performance of a Bankart repair with different devices directly postoperative and shows possible failure modes and additional injuries in case of early traumatic redislocation.
KW - Bankart lesion
KW - Shoulder instability
KW - Shoulder reconstruction
KW - Suture anchors
UR - http://www.scopus.com/inward/record.url?scp=19044364802&partnerID=8YFLogxK
U2 - 10.1016/j.arthro.2005.01.012
DO - 10.1016/j.arthro.2005.01.012
M3 - Article
C2 - 15891730
AN - SCOPUS:19044364802
SN - 0749-8063
VL - 21
SP - 611
EP - 619
JO - Arthroscopy - Journal of Arthroscopic and Related Surgery
JF - Arthroscopy - Journal of Arthroscopic and Related Surgery
IS - 5
ER -